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A CT-based approach with 3D modeling to determine optimal radiographic views of the scaphotrapezial and scaphotrapezoid joints

      Highlights

      • Review current radiographic views of scaphotrapezial and scaphotrapezoid joints
      • Describe current challenges involved in radiographic imaging of these joints
      • Calculate planes of best fit for both joints using 3D-CT reconstructions
      • Demonstrate patient positioning for novel radiographic views of these joints
      • Further studies required to assess efficacy of these views in detecting pathology.

      Abstract

      Purpose

      To use a CT-based approach with 3D modeling to determine novel radiographic views of the scaphotrapezial (STl) and scaphotrapezoid (STd) joints.

      Materials and methods

      Consecutive wrist CT scans excluding those with pathology of the distal radius, scaphoid, trapezium, or trapezoid of subjects between ages 18 and 60 years were retrospectively reviewed. Three-dimensional reconstructions of CT scans were created and best-fit planes of the STl and STd joints were generated. Angles of these planes relative to a distal radial coordinate system were calculated to determine tilt of the wrist and the X-ray beam for novel radiographic views of these joints.

      Results

      Fifty eligible wrist CT scans were identified. The mean age was 38 years (range, 18 to 59). For the novel STl PA view, the wrist is supinated 17° from the standard PA view and the X-ray beam is canted 6° caudad. In the STl lateral view, the wrist is pronated 17° from the standard lateral view, and the X-ray beam is canted 20° caudad. In the STd PA tilt view, the wrist is supinated 28° from the standard PA view, and the X-ray beam is canted 13° caudad. In the STd joint lateral tilt view, the wrist is pronated 28° from the standard lateral view, and the X-ray beam is canted 29° caudad.

      Conclusion

      We describe novel radiographic views of the STl and STd joints based on 3D modeling of wrist CT scans. Further studies are required to assess the efficacy of these views in detecting joint pathology.

      Keywords

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      References

        • Sodha S.
        • Ring D.
        • Zurakowski D.
        • Jupiter J.B.
        Prevalence of osteoarthrosis of the trapeziometacarpal joint.
        J Bone Joint Surg Am. 2005; 87: 2614-2618https://doi.org/10.2106/JBJS.E.00104
        • Katzel E.B.
        • Bielicka D.
        • Shakir S.
        • Fowler J.
        • Buterbaugh G.A.
        • Imbriglia J.E.
        Midcarpal and scaphotrapeziotrapezoid arthritis in patients with carpometacarpal arthritis.
        Plast Reconstr Surg. 2016; 137: 1793-1798https://doi.org/10.1097/PRS.0000000000002160
        • Tomaino M.M.
        • Vogt M.
        • Weiser R.
        Scaphotrapezoid arthritis: prevalence in thumbs undergoing trapezium excision arthroplasty and efficacy of proximal trapezoid excision.
        J Hand Surg. 1999; 24: 1220-1224https://doi.org/10.1053/jhsu.1999.1220
        • Irwin A.S.
        • Maffulli N.
        • Chesney R.B.
        Scapho-trapezoid arthritis. A cause of residual pain after arthroplasty of the trapezio-metacarpal joint.
        J Hand Surg (Edinb Scotl). 1995; 20: 346-352
        • North E.R.
        • Eaton R.G.
        Degenerative joint disease of the trapezium: a comparative radiographic and anatomic study.
        J Hand Surg. 1983; 8: 160-166
        • Brown G.D.
        • Roh M.S.
        • Strauch R.J.
        • Rosenwasser M.P.
        • Ateshian G.A.
        • Mow V.C.
        Radiography and visual pathology of the osteoarthritic scaphotrapezio-trapezoidal joint, and its relationship to trapeziometacarpal osteoarthritis.
        J Hand Surg. 2003; 28: 739-743
        • Tumilty J.A.
        • Squire D.S.
        Unrecognized chondral penetration by a Herbert screw in the scaphoid.
        J Hand Surg. 1996; 21: 66-68https://doi.org/10.1016/S0363-5023(96)80155-9
        • Adams B.D.
        • Blair W.F.
        • Reagan D.S.
        • Grundberg A.B.
        Technical factors related to Herbert screw fixation.
        J Hand Surg. 1988; 13: 893-899https://doi.org/10.1016/0363-5023(88)90267-5
        • Filan S.L.
        • Herbert T.J.
        Herbert screw fixation of scaphoid fractures.
        J Bone Joint Surg Br. 1996; 78: 519-529
        • McQueen M.M.
        • Gelbke M.K.
        • Wakefield A.
        • Will E.M.
        • Gaebler C.
        Percutaneous screw fixation versus conservative treatment for fractures of the waist of the scaphoid.
        Bone Jt J. 2008; 90–B: 66-71https://doi.org/10.1302/0301-620X.90B1.19767
        • Geurts G.
        • van Riet R.
        • Meermans G.
        • Verstreken F.
        Incidence of scaphotrapezial arthritis following volar percutaneous fixation of nondisplaced scaphoid waist fractures using a transtrapezial approach.
        J Hand Surg. 2011; 36: 1753-1758https://doi.org/10.1016/j.jhsa.2011.08.031
        • Wollstein R.
        • Wandzy N.
        • Mastella D.J.
        • Carlson L.
        • Watson H.K.
        A radiographic view of the scaphotrapezium-trapezoid joint.
        J Hand Surg. 2005; 30: 1161-1163https://doi.org/10.1016/j.jhsa.2005.05.009
        • Fowler J.R.
        • Hughes T.B.
        Scaphoid fractures.
        Clin Sports Med. 2015; 34: 37-50https://doi.org/10.1016/j.csm.2014.09.011
        • Mann F.A.
        • Wilson A.J.
        • Gilula L.A.
        Radiographic evaluation of the wrist: what does the hand surgeon want to know?.
        Radiology. 1992; 184: 15-24https://doi.org/10.1148/radiology.184.1.1609073
        • Maizlin Z.V.
        • Vos P.M.
        How to measure scapholunate and Cobb's angles on MRI and CT.
        J Digit Imaging. 2012; 25: 558-561https://doi.org/10.1007/s10278-011-9438-2
        • Schwarcz Y.
        • Schwarcz Y.
        • Peleg E.
        • Joskowicz L.
        • Wollstein R.
        • Luria S.
        Three-dimensional analysis of acute scaphoid fracture displacement: proximal extension deformity of the scaphoid.
        J Bone Joint Surg Am. 2017; 99: 141-149https://doi.org/10.2106/JBJS.16.00021
        • Luria S.
        • Hoch S.
        • Liebergall M.
        • Mosheiff R.
        • Peleg E.
        Optimal fixation of acute scaphoid fractures: finite element analysis.
        J Hand Surg. 2010; 35: 1246-1250https://doi.org/10.1016/j.jhsa.2010.05.011
        • Luria S.
        • Schwarcz Y.
        • Wollstein R.
        • Emelife P.
        • Zinger G.
        • Peleg E.
        3-Dimensional analysis of scaphoid fracture angle morphology.
        J Hand Surg. 2015; 40: 508-514https://doi.org/10.1016/j.jhsa.2014.11.008
        • Leventhal E.L.
        • Wolfe S.W.
        • Walsh E.F.
        • Crisco J.J.
        A computational approach to the “optimal” screw axis location and orientation in the scaphoid bone.
        J Hand Surg. 2009; 34: 677-684https://doi.org/10.1016/j.jhsa.2009.01.011
        • Schweizer A.
        • Mauler F.
        • Vlachopoulos L.
        • Nagy L.
        • Fürnstahl P.
        Computer-assisted 3-dimensional reconstructions of scaphoid fractures and nonunions with and without the use of patient-specific guides: early clinical outcomes and postoperative assessments of reconstruction accuracy.
        J Hand Surg. 2016; 41: 59-69https://doi.org/10.1016/j.jhsa.2015.10.009
        • Boyer M.I.
        • Korcek K.J.
        • Gelberman R.H.
        • Gilula L.A.
        • Ditsios K.
        • Evanoff B.A.
        Anatomic tilt X-rays of the distal radius: an ex vivo analysis of surgical fixation 1.
        J Hand Surg. 2004; 29: 116-122https://doi.org/10.1016/j.jhsa.2003.09.004
        • Julious S.A.
        Sample size of 12 per group rule of thumb for a pilot study.
        Pharm Stat. 2005; 4: 287-291https://doi.org/10.1002/pst.185
        • Taleisnik J.
        Radiographic examination of the wrist.
        in: The wrist. 1st ed. Churchill Livingstone, New York1985: 79-104
        • Moritomo H.
        • Viegas S.F.
        • Nakamura K.
        • Dasilva M.F.
        • Patterson R.M.
        The scaphotrapezio-trapezoidal joint. Part 1: an anatomic and radiographic study.
        J Hand Surg. 2000; 25: 899-910https://doi.org/10.1053/jhsu.2000.4582