The use of single photon emission computed tomography/computed tomography to differentiate between pain arising from trapeziometacarpal joint and scaphotrapeziotrapezoid joint osteoarthritis

Rijn, S. F. van; Vries, Mark R. de; Kraan, Gerald

doi:10.1177/1753193415606070

Cited by 1 publication

(1 citation statement)

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“…developments of specific sequences can quantitatively analyse cartilage or define alterations in its composition [19]. Single-photon emission computed tomography combined with conventional CT (SPECT/CT) can be used to discriminate between pain arising from the TMC or the STT joint [20]. In patients with persistent postoperative pain SPECT is a good adjunct, as other forms of imaging can be difficult to evaluate owing to residual changes from the intervention [21].…”

Section: Conventional Radiographsmentioning

confidence: 99%

Trapeziometacarpal osteoarthritis – a stepwise therapeutic approach

Nuessle¹,

Vögelin²,

Hirsiger³

2021

Swiss Med Wkly

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Osteoarthritis of the trapeziometarcarpal joint, also called rhizarthrosis, is a common finding in the second half of life. It has a higher prevalence in females and is of growing importance in ageing societies. A variety of conservative and surgical treatment options are known, including conservative treatment up to joint replacement. Without treatment, rhizarthrosis can lead to disabling pain and loss of hand function. The goal of this overview of treatment options is to present a stepwise approach that can be initiated by any physician.Treatment of trapeziometacarpal osteoarthritis should be started early with conservative measures such as splinting and physical therapy, which can be supplemented by oral and topical analgesics and local infiltrations subsequently. If all of these interventions do not provide sufficient relief, referral to a hand surgeon should be considered.Surgical strategies vary from arthroscopic debridement over trapeziectomy, with or without tendon interposition and ligament reconstruction, to interposition implants and total joint replacements. The planned intervention should be based on clinical and subjective functional limitations and associated degenerative changes, as well as the patient's expectations and needs.The goal of this paper is to develop a treatment algorithm, leading to higher levels of patient functionality and satisfaction. Below we discuss the current literature and point out key treatment options used in our department. Additional imagingMultilayer imaging can help to evaluate the trapeziometacarpal joint and the neighbouring joints in more detail. To evaluate bone stock and cartilage surfaces, and especially if planning prosthetic implants, computed tomography (CT) enhanced by intra-articular contrast injection can be useful [18]. Magnetic resonance imaging (MRI) allows ligament and soft tissue evaluation. Recent

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Section: Conventional Radiographsmentioning

confidence: 99%