scholarly journals Evaluation of Four-Dimensional Computed Tomography as a Technique for Quantifying Carpal Motion

2021 ◽  
Vol 143 (6) ◽  
Author(s):  
Sydney Robinson ◽  
Lauren Straatman ◽  
Ting-Yim Lee ◽  
Nina Suh ◽  
Emily Lalone
Keyword(s):  
Computed Tomography ◽  
Local Coordinate System ◽  
Joint Surface ◽  
Diagnostic Tools ◽  
Neutral Position ◽  
Ulnar Deviation ◽  
Joint Congruency ◽  
Flexion Extension ◽  
Carpal Mechanics ◽  
Static Conditions

Abstract Delayed diagnosis of dynamic carpal instability often occurs because early changes in bone alignment and movement are difficult to detect and manifest mainly during a dynamic/functional task. Current diagnostic tools are only able to examine the carpal bones under static or sequential-static conditions. Four-dimensional (three dimensions + time) computed tomography (4DCT) enables quantification of carpal mechanics through 3D volume sequences of the wrist in motion. A comprehensive understanding of carpal mechanics is needed to define normal function and structure and provide targets for treatment of carpal injuries. In this study, measurements of scaphoid translation and joint congruency were taken by creating models from the CT scans of the carpals in extreme frames of motion, registering those models to the neutral position, transforming the models into a local coordinate system, and using software to calculate the joint surface areas (JSA). Results indicated that the centroid of the scaphoid translated 6.4 ± 1.3 mm and extended from extreme radial to extreme ulnar deviation. Results are consistent with the literature. An additional study was performed to measure the responsiveness of the 4DCT technique presented. Bone models from each frame of motion for radio ulnar deviation (RUD) and flexion extension (FE) were created and distinct differences between their JSA were measured qualitatively and quantitatively. The results show that there was statistically significantly different JSA within carpal joints between RUD and FE. These studies provide the first step in developing the methodology when using 4DCT scanning to measure subtle abnormalities in the wrist.

scholarly journals Effects of axial load on in vivo scaphoid and lunate kinematics using four-dimensional computed tomography

2020 ◽  
Vol 45 (9) ◽  
pp. 974-980
Author(s):  
Michelle Brinkhorst ◽  
Geert Streekstra ◽  
Joost van Rosmalen ◽  
Simon Strackee ◽  
Steven Hovius
Keyword(s):  
Computed Tomography ◽  
Axial Load ◽  
In Vivo Study ◽  
Ulnar Deviation ◽  
Flexion Extension ◽  
Flexion And Extension

This in vivo study investigated the effect of axial load on lunate and scaphoid kinematics during flexion–extension and radial–ulnar deviation of the uninjured wrist using four-dimensional computed tomography. We found that applying axial load to the wrist results in a more flexed, radially deviated and pronated position of the lunate and scaphoid during flexion–extension of the wrist compared with when no load is applied. A larger pronation and supination range of the lunate and scaphoid was seen when the wrist was flexed and extended under axial load, whereas a larger flexion and extension range of the lunate and scaphoid occurred during radial–ulnar deviation of the wrist when axial load was applied.

Does Wrist Laxity Influence Three-Dimensional Carpal Bone Motion?

2018 ◽  
Vol 140 (4) ◽  
Author(s):  
Gordon M. Best ◽  
Michelle L. Zec ◽  
David R. Pichora ◽  
Robin N. Kamal ◽  
Michael J. Rainbow
Keyword(s):  
Three Dimensional ◽  
Carpal Bone ◽  
Patient Specific ◽  
Wrist Flexion ◽  
Ulnar Deviation ◽  
Column Type ◽  
Flexion Extension ◽  
Carpal Kinematics ◽  
Carpal Mechanics

Previous two-dimensional (2D) studies have shown that there is a spectrum of carpal mechanics that varies between row-type motion and column-type motion as a function of wrist laxity. More recent three-dimensional (3D) studies have suggested instead that carpal bone motion is consistent across individuals. The purpose of this study was to use 3D methods to determine whether carpal kinematics differ between stiffer wrists and wrists with higher laxity. Wrist laxity was quantified using a goniometer in ten subjects by measuring passive wrist flexion–extension (FE) range of motion (ROM). In vivo kinematics of subjects' scaphoid and lunate with respect to the radius were computed from computed tomography (CT) volume images in wrist radial and ulnar deviation positions. Scaphoid and lunate motion was defined as “column-type” if the bones flexed and extended during wrist radial–ulnar deviation (RUD), and “row-type” if the bones radial–ulnar deviated during wrist RUD. We found that through wrist RUD, the scaphoid primarily flexed and extended, but the scaphoids of subjects with decreased laxity had a larger component of RUD (R2 = 0.48, P < 0.05). We also determined that the posture of the scaphoid in the neutral wrist position predicts wrist radial deviation (RD) ROM (R2 = 0.46, P < 0.05). These results suggest that ligament laxity plays a role in affecting carpal bone motion of the proximal row throughout radial and ulnar deviation motions; however, other factors such as bone position may also affect motion. By developing a better understanding of normal carpal kinematics and how they are affected, this will help physicians provide patient-specific approaches to different wrist pathologies.

scholarly journals Validation and application of a novel in vivo cervical spine kinematics analysis technique

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Zongmiao Wan ◽  
Wenjin Wang ◽  
Chao Li ◽  
Junjie Li ◽  
Jinpeng Lin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Young Adults ◽  
Cervical Spine ◽  
Cervical Vertebrae ◽  
Upper Cervical Spine ◽  
Neutral Position ◽  
Registration Errors ◽  
Spine Kinematics ◽  
Flexion Extension

AbstractTo validate the accuracy of Cone beam computed tomography (CBCT) cervical spine modeling with three dimensional (3D)-3D registration for in vivo measurements of cervical spine kinematics. CBCT model accuracy was validated by superimposition with computed tomography (CT) models in 10 healthy young adults, and then cervical vertebrae were registered in six end positions of functional movements, versus a neutral position, in 5 healthy young adults. Registration errors and six degrees of freedom (6-DOF) kinematics were calculated and reported. Relative to CT models, mean deviations of the CBCT models were < 0.6 mm. Mean registration errors between end positions and the reference neutral position were < 0.7 mm. During flexion–extension (F–E), the translation in the three directions was small, mostly < 1 mm, with coupled LB and AR both < 1°. During lateral bending (LB), the bending was distributed roughly evenly, with coupled axial rotation (AR) opposite to the LB at C1–C2, and minimal coupled F–E. During AR, most of the rotation occurred in the C1–C2 segment (29.93 ± 7.19° in left twist and 31.38 ± 8.49° in right twist) and coupled LB was observed in the direction opposite to that of the AR. Model matching demonstrated submillimeter accuracy in cervical spine kinematics data. The presently evaluated low-radiation-dose CBCT technique can be used to measure 3D spine kinematics in vivo across functional F–E, AR, and LB positions, which has been especially challenging for the upper cervical spine.

Scaphoid Motion of the Wrist with Scapho-trapezio-trapezoidal Osteoarthritis-A Pilot Study

2020 ◽  
Vol 16 (3) ◽  
pp. 206-209
Author(s):  
Ronit Wollstein ◽  
Hisao Moritomo ◽  
Iida Akio ◽  
Shohei Omokawa
Keyword(s):  
Neutral Position ◽  
Wrist Flexion ◽  
Wrist Movement ◽  
Ulnar Deviation ◽  
Wrist Motion ◽  
3 Dimensional ◽  
Active Flexion ◽  
Extended Position ◽  
Flexion Extension ◽  
Surface Models

Background: The purpose of this study was to investigate scaphoid motion within the scapho-trapezio-trapezoidal (STT) joint during wrist motion in the presence of STT joint osteoarthritis (OA). Methods: We studied 11 wrists with STT OA and 5 normal wrists. Computed tomography (CT) images were acquired in five wrist positions (maximum active flexion, extension, radial deviation, ulnar deviation, and neutral position). The 3-dimensional surface models of the radius and scaphoid were constructed and the motion of scaphoid relative to the radius was calculated. Results and Conclusion: During wrist flexion/extension motion, the scaphoid rotated mostly in the flexion/extension plane. The angle tended to be smaller in STT OA than in normal. During wrist radioulnar deviation, the scaphoid was in an extended position in neutral wrist in STT OA. The motion of scaphoid in STT OA was divided into two types: a rigid type and mobile type. The mobile type rotated closer to the flexion/extension plane than the rigid type. Taking into account scaphoid motion during wrist movement before surgery may provide better results in the treatment of STT OA.

Total Wrist Arthroplasty Alignment and Its Potential Association with Clinical Outcomes

2021 ◽  
Author(s):  
Bardiya Akhbari ◽  
Kalpit N. Shah ◽  
Amy M. Morton ◽  
Janine Molino ◽  
Douglas C. Moore ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Outcomes ◽  
Three Dimensional ◽  
Radial Component ◽  
Single Type ◽  
Radiographic Images ◽  
Computed Tomography Images ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Wrist Arthroplasty

Abstract Purpose There is a lack of quantitative research that describes the alignment and, more importantly, the effects of malalignment on total wrist arthroplasty (TWA). The main goal of this pilot study was to assess the alignment of TWA components in radiographic images and compare them with measures computed by three-dimensional analysis. Using these measures, we then determined if malalignment is associated with range of motion (ROM) or clinical outcomes (PRWHE, PROMIS, QuickDash, and grip strength). Methods Six osteoarthritic patients with a single type of TWA were recruited. Radiographic images, computed tomography images, and clinical outcomes of the wrists were recorded. Using posteroanterior and lateral radiographs, alignment measurements were defined for the radial and carpal components. Radiographic measurements were validated with models reconstructed from computed tomography images using Bland–Altman analysis. Biplanar videoradiography (<1mm and <1 degree accuracy) was used to capture and compute ROM of the TWA components. Linear regression assessed the associations between alignment and outcomes. Results Radiographic measures had a 95% limit-of-agreement (mean difference ±  1.96 × SD) of 3 degrees and 3mm with three-dimensional values, except for the measures of the carpal component in the lateral view. In our small cohort, wrist flexion–extension and radial–ulnar deviation were correlated with volar–dorsal tilt and volar–dorsal offset of the radial component and demonstrated a ROM increase of 3.7 and 1.6 degrees per degree increase in volar tilt, and 10.8 and 4.2 degrees per every millimeter increase in volar offset. The carpal component's higher volar tilt was also associated with improvements in patient-reported pain. Conclusions We determined metrics describing the alignment of TWA, and found the volar tilt and volar offset of the radial component could potentially influence the replaced wrist's ROM. Clinical Relevance TWA component alignment can be measured reliably in radiographs, and may be associated with clinical outcomes. Future studies must evaluate its role in a larger cohort.

scholarly journals Radiological Findings in Multidetector Computed Tomography (MDCT) of Hereditary and Sporadic Pulmonary Veno-Occlusive Disease: Certainties and Uncertainties

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 141
Author(s):  
Marta Pérez Núñez ◽  
Sergio Alonso Charterina ◽  
Carmen Pérez-Olivares ◽  
Yolanda Revilla Ostolaza ◽  
Rafael Morales Ruiz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Poor Response ◽  
Occlusive Disease ◽  
Diagnostic Tools ◽  
Lung Edema ◽  
Consecutive Series ◽  
Radiological Findings ◽  
Vasodilator Treatment ◽  
Aggressive Clinical Course

Pulmonary veno-occlusive disease (PVOD) is a very infrequent form of pulmonary arterial hypertension with an aggressive clinical course, poor response to specific vasodilator treatment, and low survival. Confirming a definitive diagnosis is essential to guide treatment and assess lung transplantation. However, in the absence of histological or genetic confirmation, the diagnosis is complex, requiring a clinical suspicion. Multidetector computed tomography (MDCT) is an essential part of the non-invasive diagnostic tools of PVOD. We retrospectively reviewed the MDCT findings from a consecutive series of 25 patients diagnosed with PVOD, 9 with the sporadic form and 16 with the hereditary form of the disease. The presence and extent of typical findings of the diagnostic triad were assessed in all patients (ground glass parenchymal involvement, septal lines, and lymphadenopathy). In our series, 92% of patients showed at least two of the radiological findings described as typical of the disease. All patients presented at least one typical radiological characteristic. The incidence of radiological findings considered typical is very high, however was not associated with greater hemodynamic severity nor to the development of acute lung edema. No significant differences were found between the two groups. A poorly expressive MDCT does not exclude the disease.

scholarly journals Multi-detector computed tomography (MDCT) as a diagnostic tool in assessment of thoracic aortic anomalies in pediatric patients

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Dawlat Nader Eltatawy ◽  
Fatma Anas Elsharawy ◽  
Aly Aly Elbarbary ◽  
Raghda Ghonimy Elsheikh ◽  
Manal Ezzat Badawy
Keyword(s):  
Computed Tomography ◽  
Aortic Arch ◽  
Pediatric Patients ◽  
Interrupted Aortic Arch ◽  
Diagnostic Tools ◽  
Non Invasive ◽  
Branching Patterns ◽  
Anatomic Variants ◽  
Multi Detector Computed Tomography

Abstract Background A wide variety of congenital thoracic aortic variants and pathological anomalies could be assessed recently in diagnostic and interventional radiology. Multi-detector computed tomography (MDCT) is one of the most important non-invasive diagnostic tools for their detection. The aim of the study was to evaluate role of MDCT scanning for diagnosis of thoracic aortic anatomic variants and diseases in pediatric patients. Results Thirty patients (15 male and 15 female), mean age (8.49 ± 20.29 months) were diagnosed with different thoracic aortic anomalies by MDCT then confirmed by surgical results. MDCT was more sensitive than echocardiography in detection of hypo plastic arch, vascular rings, interrupted aortic arch anomalies, and aortic coarctation. Both MDCT and echocardiography showed 100% sensitivity in their detection of TGA, TOF, and PDA. MDCT detected 6 cases of right-sided aortic arch while echo missed 2 cases. Different aortic arch branching patterns and coronary origin were better demonstrated by MDCT. Conclusion 320-Multi-detector computed tomography is a reliable tool for optimal detection of thoracic aortic anomalies and preoperative planning.

Quantification of Hand Grip Force under Dynamic Conditions

1993 ◽  
Vol 37 (10) ◽  
pp. 715-719 ◽  
Author(s):  
Katherine R. Lehman ◽  
W. Gary Allread ◽  
P. Lawrence Wright ◽  
William S. Marras
Keyword(s):  
Grip Force ◽  
Wrist Flexion ◽  
Range Of Movement ◽  
Ulnar Deviation ◽  
Dynamic Conditions ◽  
Radial Deviation ◽  
Hand Grip ◽  
Flexion Extension ◽  
Maximum Grip ◽  
Lower Grip

A laboratory experiment was conducted to determine whether grip force capabilities are lower when the wrist is moved than in a static position. The purpose was to determine the wrist velocity levels and wrist postures that had the most significant effect on grip force. Maximum grip forces of five male and five female subjects were determined under both static and dynamic conditions. The dominant wrist of each subject was secured to a CYBEX II dynamometer and grip force was collected during isokinetic wrist deviations for four directions of motion (flexion to extension, extension to flexion, radial to ulnar, and ulnar to radial). Six different velocity levels were analyzed and grip forces were recorded at specific wrist positions throughout each range of movement. For flexion-extension motions, wrist positions from 45 degrees flexion to 45 degrees extension were analyzed whereas positions from 20 degrees radial deviation to 20 degrees ulnar deviation were studied for radial-ulnar activity. Isometric exertions were also performed at each desired wrist position. Results showed that, for all directions of motion, grip forces for all isokinetic conditions were significantly lower than for the isometric exertions. Lower grip forces were exhibited at extreme wrist flexion and extreme radial and ulnar positions for both static and dynamic conditions. The direction of motion was also found to affect grip strength; extension to flexion exertions produced larger grip forces than flexion to extension exertions and radial to ulnar motion showed larger grip forces than ulnar to radial deviation. Although, males produced larger grip forces than females in all exertions, significant interactions between gender and velocity were noted.

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