In wrist pathology, there is a need to establish the normal range of radiographic measurement parameters. Previous study showed that the contralateral wrist might not be valid as a reference for all parameters. There is a lack of literature describing the normal range of wrist radiographic parameters in literature. As a result, a retrospective study was carried out. Patients who underwent standard wrist x-rays during the period February 2012 to February 2013 (one single year) were retrospectively reviewed. 71 patients were included. Scapholunate angle was 54.7° (±6.5°). Scapholunate interval was 2.0 mm (±0.4 mm). Ulnar variance was +1.0 mm (±1.8 mm). Carpal height was 31.8 mm (±3.0 mm). Radial inclination was 25.1° (±2.1°). All 71 patients had 1 sesamoid bone at first metacarpal. 16.9% (12 out of 71) patients had positive cortical ring signs. All these parameters are valuable clinically, especially in monitoring of the wrist disease progression, in the design of wrist implants and for future clinical research.
References
[1]
Schuind, F., Alemzadeh, S., Stallenberg, B. and Burny, F. (1996) Does the Normal Contralateral Wrist Provide the Best Reference for X-Ray Film Measurements of the Pathologic Wrist? Journal of Hand Surgery, 21, 24-30. https://doi.org/10.1016/S0363-5023(96)80150-X
[2]
Schimmerl-Metz, S.M., Metz, V.M., Totterman, S.M., Mann, F.A. and Gilula, L.A. (1999) Radiologic Measurement of the Scapholunate Joint: Implications of Biologic Variation in Scapholunate Joint Morphology. Journal of Hand Surgery, 24, 1237-1244. https://doi.org/10.1053/jhsu.1999.1237
[3]
Schuind, F., Eslami, S. and Ledoux, P. (2008) Kienböck’s Disease. The Bone & Joint Journal, 90, 133-139. https://doi.org/10.1302/0301-620X.90B2.20112
[4]
Ramos-Escalona, J., Garcia-Bordes, L., Martinez-Galarza, P. and Yunta-Gallo, A. (2010) Ulnar Variance and Scaphoid Fracture. Journal of Hand Surgery (European Volume), 35, 195-197. https://doi.org/10.1177/1753193409352281
[5]
Voorhees, D.R., Daffner, R.H., Nunley, J.A. and Gilula, L.A. (1985) Carpal Ligamentous Disruptions and Negative Ulnar Variance. Skeletal Radiology, 13, 257-262. https://doi.org/10.1007/BF00355345
[6]
Jafari, D., Taheri, H., Shariatzade, H., Mazhar, F.N., Jalili, A. and Ghahramani, M. (2012) Radiographic Indices in One Hundred Fifty Normal Iranian Wrists. Medical Journal of the Islamic Republic of Iran, 26, 132-139.
[7]
Schuind, F.A., Linscheid, R.L., An, K.N. and Chao, E.Y. (1992) A Normal Data Base of Posteroanterior Roentgenographic Measurements of the Wrist. The Journal of Bone & Joint Surgery, 74, 1418-1429. https://doi.org/10.2106/00004623-199274090-00018
[8]
Loredo, R.A., Sorge, D.G. and Garcia, G. (2005) Radiographic Evaluation of the Wrist: A Vanishing Art. Seminars in Roentgenology, 40, 248-289. https://doi.org/10.1053/j.ro.2005.01.014
[9]
Kitay, A. and Wolfe, S.W. (2012) Scapholunate Instability: Current Concepts in Diagnosis and Management. Journal of Hand Surgery, 37, 2175-2196. https://doi.org/10.1016/j.jhsa.2012.07.035
[10]
Gilula, L.A. and Weeks, P.M. (1978) Post-Traumatic Ligamentous Instabilities of the Wrist. Radiology, 129, 641-651. https://doi.org/10.1148/129.3.641
[11]
Gradl, G., Neuhaus, V., Fuchsberger, T., Guitton, T.G., Prommersberger, K.J. and Ring, D. (2013) Radiographic Diagnosis of Scapholunate Dissociation among Intra-Articular Fractures of the Distal Radius: Interobserver Reliability. Journal of Hand Surgery, 38, 1685-1690. https://doi.org/10.1016/j.jhsa.2013.05.039
[12]
Giunta, R.E., Biemer, E. and Muller-Gerbl, M. (2004) Ulnar Variance and Subchondral Bone Mineralization Patterns in the Distal Articular Surface of the Radius. Journal of Hand Surgery, 29, 835-840. https://doi.org/10.1016/j.jhsa.2004.05.015
[13]
Gelberman, R.H., Salamon, P.B., Jurist, J.M. and Posch, J.L. (1975) Ulnar Variance in Kienbock’s Disease. The Journal of Bone & Joint Surgery, 57, 674-676. https://doi.org/10.2106/00004623-197557050-00017
[14]
Tsuge, S. and Nakamura, R. (1993) Anatomical Risk Factors for Kienbock’s Disease. Journal of Hand Surgery (European Volume), 18, 70-75. https://doi.org/10.1016/0266-7681(93)90201-P
[15]
Lichtman, D.M., Pientka II, W.F. and Bain, G. I. (2017) Kienbock Disease: A New Algorithm for the 21st Century. Journal of Wrist Surgery, 6, 2-10. https://doi.org/10.1055/s-0036-1593734
[16]
Bessho, Y., Nakamura, T., Nishiwaki, M., Nagura, T., Matsumoto, M., Nakamura, M. and Sato, K. (2018) Effect of Decrease in Radial Inclination of Distal Radius Fractures on Distal Radioulnar Joint Stability: A Biomechanical Study. Journal of Hand Surgery (European Volume).
[17]
Nishiwaki, M., Nakamura, T., Nagura, T., Toyama, Y. and Ikegami, H. (2008) Ulnar-Shortening Effect on Distal Radioulnar Joint Pressure: A Biomechanical Study. Journal of Hand Surgery, 33, 198-205. https://doi.org/10.1016/j.jhsa.2007.11.024
[18]
Kim, J.Y., Sung, J.H. and Seo, J.G. (2011) Sesamoid Arthritis Mimicking Trigger Thumb. Orthopedics, 34, 228.
[19]
Abe, Y., Doi, K. and Hattori, Y. (2008) The Clinical Significance of the Scaphoid Cortical Ring Sign: A Study of Normal Wrist X-Rays. Journal of Hand Surgery (European Volume), 33, 126-129. https://doi.org/10.1177/1753193407087572
