Reliability and Normal Values of Various Computed Tomography Methods for Quantifying Distal Radioulnar Joint Translation

2009 ◽  
Vol 2009 ◽  
pp. 224-225
Author(s):  
S.G. Edwards
Keyword(s):  
Computed Tomography ◽  
Normal Values ◽  
Distal Radioulnar Joint ◽  
Radioulnar Joint

Normal Values of Distal Radioulnar Joint Kinematics during a Dynamic Press Test

2021 ◽  
Author(s):  
Janni Kjærgaard Thillemann ◽  
Sepp De Raedt ◽  
Emil Toft Petersen ◽  
Katriina Bøcker Puhakka ◽  
Torben Bæk Hansen ◽  
...  
Keyword(s):  
Normal Values ◽  
Intraclass Correlation ◽  
Case Series ◽  
Distal Radioulnar Joint ◽  
Ulnar Variance ◽  
Patient Specific ◽  
Imaging Method ◽  
Radioulnar Joint ◽  
Case Series Study ◽  
The Press

Abstract Background Measurement of in vivo distal radioulnar joint (DRUJ) pathomechanics during simple activities can represent the disability experienced by patients and may be useful in diagnostics of DRUJ instability. A first step is to describe the physiological normal limits for DRUJ kinematics in a reproducible and precise test setup, which was the aim of this study. Methods DRUJ kinematics were evaluated in 33 participants with dynamic radiostereometry (RSA) while performing a standardized press test examination. AutoRSA software was used for image analyses. Computed tomography (CT) forearm bone models were generated, and standardized anatomical axes were applied to estimate kinematic outcomes including, DRUJ translation, DRUJ position ratio, and changes in ulnar variance. Repeatability of dynamic RSA press test double examinations was evaluated to estimate the precision and intraclass correlation coefficient (ICC) test–retest agreement. Results The maximum force during the press test was 6.0 kg (95% confidence interval [CI]: 5.1–6.9), which resulted in 4.7 mm (95% CI: 4.2–5.1) DRUJ translation, DRUJ position ratio of 0.40 (95% CI: 0.33–0.44), and increase in ulnar variance of 1.1 mm (95% CI: 1.0–1.2). The mean maximum DRUJ translation leveled off after a 5 kg force application. The DRUJ translation ICC coefficient was 0.93 within a prediction interval of ± 0.53mm. Conclusions This clinical study demonstrates the normal values of DRUJ kinematics and reports excellent agreement and high precision of the press tests examination using an automated noninvasive dynamic RSA imaging method based on patient-specific CT bone models. The next step is the application of the method in patients with arthroscopic verified triangular fibrocartilage complex injuries. Level of Evidence This is a Level IV, case series study.

Criteria for diagnosing distal radioulnar joint subluxation by computed tomography

1996 ◽  
Vol 25 (7) ◽  
pp. 649-653 ◽  
Author(s):  
R. Nakamura ◽  
Emiko Horii ◽  
Toshihiko Imaeda ◽  
Etsuhiro Nakao
Keyword(s):  
Computed Tomography ◽  
Distal Radioulnar Joint ◽  
Radioulnar Joint ◽  
Distal Radioulnar Joint Subluxation

Kinematic Analysis of the Distal Radioulnar Joint in Asymptomatic Wrists Using 4-Dimensional Computed Tomography–Motion Pattern and Interreader Reliability

2019 ◽  
Vol 43 (3) ◽  
pp. 392-398
Author(s):  
Delaram Shakoor ◽  
Nima Hafezi-Nejad ◽  
Arya Haj-Mirzaian ◽  
Jaimie T. Shores ◽  
Scott D. Lifchez ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Kinematic Analysis ◽  
Distal Radioulnar Joint ◽  
Motion Pattern ◽  
Radioulnar Joint

Ulnar Stump Stabilization Using the Flexor Carpi Ulnaris Tendon for the Rheumatoid Wrist

2019 ◽  
Vol 24 (04) ◽  
pp. 447-451 ◽  
Author(s):  
Asami Abe ◽  
Hajime IshikawaKim
Keyword(s):  
Computed Tomography ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Forearm Rotation ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Ulnar Head Resection ◽  
Flexor Carpi Ulnaris ◽  
Grip Power

Background: The objective of this retrospective study was to evaluate the outcomes of ulnar stump stabilization after ulna head resection using the FCU tendon by investigating the rate of postoperative extensor tendon rupture and click on forearm rotation. Methods: Wrist synovectomy (distal radioulnar joint (DRUJ), radiocarpal and midcarpal joints) and ulnar head resection combined with ulnar stump stabilizing procedure were performed in 58 wrists of 53 patients with RA in our hospital. Before operation, the dorsal subluxation ratio (DSR) of the ulnar head was measured with a multi-slice computed tomography (CT) images. The stabilization of ulnar stump after head resection was performed by the value of the DSR or the instability before the operation. Results: There was neither extensor tendon rupture nor click on forearm rotation in all the patients. Smooth forearm rotation was achieved by ulnar head resection and stabilizing procedure for the ulnar stump. The active range of forearm supination and pronation increased significantly from 68° ± 23° (mean ± SD) to 80° ± 10°, and from 69° ± 17° to 74° ± 13°. The grip power increased from 117 ± 62 mmHg to 185 ± 55 mmHg. In the assessment using 3DCT, the preoperative DSR of 54% improved to 8% on the whole (n = 58). In the wrists with extensor tendon rupture (n = 36), the preoperative DSR of 58% improved to 12%. In the wrists without tendon rupture (n = 22), the preoperative DSR of 46% improved to 2%. Conclusions: The operative technique of ulnar stump stabilization using the FCU tendon was one of the suitable procedure to prevent complications after ulnar head resection.

Diagnosis of distal radioulnar joint subluxation in patients with rheumatoid wrist by computed tomography

2007 ◽  
Vol 17 (4) ◽  
pp. 279-282 ◽  
Author(s):  
Shunichi Henmi ◽  
Kazuo Yonenobu ◽  
Shosuke Akita ◽  
Yusuke Kuroda ◽  
Kiyoshi Yoshida
Keyword(s):  
Computed Tomography ◽  
Distal Radioulnar Joint ◽  
Radioulnar Joint ◽  
Rheumatoid Wrist ◽  
Distal Radioulnar Joint Subluxation

Diagnostic modalities for distal radioulnar joint

2016 ◽  
Vol 42 (4) ◽  
pp. 395-404 ◽  
Author(s):  
S. Jens ◽  
T. Luijkx ◽  
F. F. Smithuis ◽  
M. Maas
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Imaging Modality ◽  
Conventional Radiography ◽  
Distal Radioulnar Joint ◽  
Resonance Imaging ◽  
Radioulnar Joint ◽  
Joint Pathology ◽  
Imaging Characteristics

The first imaging modality in patients suspected of distal radioulnar joint pathology should be conventional radiography to exclude or diagnose wrist pathology including osteoarthritis, rheumatoid arthritis, calcium pyrophosphate deposition disease, (healed) fractures, or impaction syndromes. When conventional radiography is inconclusive, high resolution 3 Tesla magnetic resonance imaging is advised. We provide a broad overview of the literature regarding the use of intra-articular contrast both with computed tomography (CTA) or magnetic resonance imaging (MRA). Conventional arthrography and unenhanced computed tomography are not indicated. This article discusses the most useful imaging techniques in terms of clinical indications, patient positioning, technical imaging requirements, and diagnostic performance in patients with suspected distal radioulnar joint pathology. Furthermore, the most prevalent pathologies are discussed, with the focus on imaging characteristics in both stable and unstable distal radioulnar joints.

Radioulnar Ratio in Detection of Distal Radioulnar Joint Instability Associated With Acute Distal Radius Fractures

2010 ◽  
Vol 35 (9) ◽  
pp. 730-734 ◽  
Author(s):  
J.H. Scheer ◽  
S. Hammerby ◽  
L.E. Adolfsson
Keyword(s):  
Computed Tomography ◽  
Prospective Study ◽  
Distal Radius ◽  
Joint Instability ◽  
Stress Test ◽  
Distal Radioulnar Joint ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Radioulnar Joint ◽  
Triangular Fibrocartilage

Lesions of the triangular fibrocartilage complex (TFCC) are commonly associated with distal radius fractures and may adversely affect the functional outcome. This prospective study evaluated computed tomography, using the radioulnar ratio (RUR), to detect laxity of the distal radioulnar joint in 48 consecutive patients with acute distal radius fractures and compared the results with a radioulnar stress test. We found the clinical stress test to be reliable in chronic cases, but the RUR method of questionable value in both acute and chronic cases.

Ulnar Styloid Fracture with Distal Radioulnar Joint Subluxation/Dislocation

Hand Surgery ◽  
1997 ◽  
Vol 02 (02) ◽  
pp. 141-147
Author(s):  
Ryogo Nakamura ◽  
Emiko Horii ◽  
Toshihiko Imaeda ◽  
Etsuhiro Nakao ◽  
Hitoshi Kato
Keyword(s):  
Computed Tomography ◽  
Distal Radioulnar Joint ◽  
Ulnar Styloid ◽  
Radioulnar Joint ◽  
Ulnar Styloid Fracture ◽  
Distal Radioulnar Joint Subluxation

In 55 patients with ulnar styloid fractures, the site and displacement of the fracture was examined in relation to distal radioulnar joint subluxation/dislocation by computed tomography (CT). Distal radioulnar joint subluxation/dislocation confirmed with CT in 18 of 55 patients, irrespective of the site of the ulnar styloid fracture. In 21 patients with nondisplaced styloid fractures, only 3 fractures were associated with distal radioulnar joint subluxation/dislocation. In 34 patients where the styloid fracture was displaced for 3 mm or more, 15 fractures were associated with a distal radioulnar joint subluxation/dislocation. Therefore, ulnar styloid displacement of 3 mm or more suggests the need for further examination of the distal radioulnar joint.

scholarly journals Normal values of distal radioulnar translation assessed by three-dimensional C-arm scans: a cadaveric study

2019 ◽  
Vol 44 (5) ◽  
pp. 503-509 ◽  
Author(s):  
Benedict Swartman ◽  
Laura Benner ◽  
Stephan Grechenig ◽  
Jochen Franke ◽  
Paul A. Grützner ◽  
...  
Keyword(s):  
Normal Values ◽  
Intraclass Correlation ◽  
Three Dimensional ◽  
Distal Radioulnar Joint ◽  
Cone Beam ◽  
Ratio Method ◽  
Reference Ranges ◽  
Radioulnar Joint ◽  
Observer Reliability ◽  
Cone Beam Computer Tomography

We investigated whether mobile C-arm cone beam computer tomography (CBCT) could be used to measure radioulnar translation. The study was conducted on 31 Thiel-fixed intact cadaver arms. Three-dimensional scans of each wrist were carried out in pronation and supination. Four established measurement methods were used (radioulnar line, subluxation ratio, epicentre and radioulnar ratio methods) to measure radioulnar translation. The intraclass correlation coefficient for inter-observer and intra-observer reliability were excellent in three of four methods (>0.94). The reference ranges for physiological radioulnar translation were between −30% and 91% (radioulnar line method), −32% and 87% (subluxation ratio method), −40% and 23% (epicentre method), and 2% and 73% (radioulnar ratio method). Our results indicate that radioulnar translation in the distal radioulnar joint can be determined reliably using mobile C-arm CBCT. The normal values provide a basis for further experimental and clinical studies.

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