Advertisement
Original Communications| Volume 26, ISSUE 2, P236-243, March 2001

Download started.

Ok

The radioulnar ratio: A new method of quantifying distal radioulnar joint subluxation

      Abstract

      Computed tomography was used to image the distal radioulnar joint (DRUJ) for instability. Four methods were used to quantify subluxation of the DRUJ: the Mino criteria, the epicenter method, the congruency method, and a new method called the radioulnar ratio (RUR). Validity of the various methods was evaluated in clinical and laboratory situations. Rheumatoid patients with symptomatic DRUJ pathology had significantly more abnormal RUR values (100% vs 73% [epicenter method] and 88% [Mino criteria]). The RUR detected instability sooner in a progressive laboratory-induced instability model. The intraobserver and interobserver reliability of the RUR was high, with intraclass correlation coefficients of 0.89 and 0.87, respectively. The RUR demonstrated superior performance in the diagnosis of DRUJ subluxation. (J Hang Surg 2001;26A:236-243. Copyright © 2001 by the American Society for Surgery of the Hand.)

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bruckner JD
        • Alexander AH
        • Lichtman DM.
        Acute dislocations of the distal radio-ulnar joint.
        J Bone Joint Surg. 1995; 77A: 958-968
        • Chidgey LK.
        The distal radioulnar joint: problems and solutions.
        J Am Acad Orthop Surg. 1995; 3: 95-109
        • Mino DE
        • Palmer AK
        • Levinsohn EM.
        The role of radiography and computerized tomography in the diagnosis of subluxation and dislocation of the distal radioulnar joint.
        J Hand Surg. 1983; 8: 23-31
        • Mino DE
        • Palmer AK
        • Levinsohn EM.
        Radiography and computerized tomography in the diagnosis of incongruity of the distal radio-ulnar joint.
        J Bone Joint Surg. 1985; 67A: 247-252
        • Yang Z
        • Mann FA
        • Gilula LA
        • Haerr C
        • Larsen CF.
        Scaphopisocapitate alignment: criterion to establish a neutral lateral view of the wrist.
        Musculoskel Radiol. 1997; 205: 865-869
        • Bond JR
        • Berquist TH.
        Radiologic evaluation of hand and wrist motion.
        Hand Clin. 1991; 7: 113-123
        • Burk DL
        • Karasick D
        • Wechsler RJ.
        Imaging of the distal radioulnar joint.
        Hand Clin. 1991; 7: 263-275
        • Levinsohn EM.
        Imaging of the wrist.
        Radiol Clin North Am. 1990; 28: 905-921
        • Wechsler RJ
        • Wehbe MA
        • Rifkin MD
        • Edeiken J
        • Branch HM.
        Computed tomography diagnosis of distal radioulnar subluxation.
        Skeletal Radiol. 1987; 16: 1-5
        • Weiler PJ
        • Bogoch ER
        Kinematics of the distal radioulnar joint in rheumatoid arthritis: an in vivo study using centrode analysis.
        J Hand Surg. 1995; 20A: 937-943
        • King GJ
        • McMurtry RY
        • Rubenstein JD
        • Ogston NG.
        Computerized tomography of the distal radioulnar joint: correlation with ligamentous pathology in a cadaveric model.
        J Hand Surg. 1986; 11A: 711-717
        • Herzog RJ.
        Technology assessment. A case study in diagnostic imaging.
        in: Orthopaedic knowledge update 4: home study syllabus. : The American Academy of Orthopaedic Surgeons, Rosemont, IL1993: 53-62
        • Shrout PE
        • Fleiss JL.
        Intraclass correlations: uses in assessing rater reliability.
        Psych Bull. 1979; 86: 420-428
        • Linscheid RL.
        Biomechanics of the distal radioulnar joint.
        Clin Orthop. 1992; 275: 45-55
        • King GJ
        • McMurtry RY
        • Rubenstein JD
        • Gertzbein SD.
        Kinematics of the distal radioulnar joint.
        J Hand Surg. 1986; 11A: 798-804
        • Cone RO
        • Szabo R
        • Resnick D
        • Gelberman R
        • Taleisnik J
        • Gilula LA.
        Computed tomography of the normal radioulnar joints.
        Invest Radiol. 1983; 18: 541-545
        • Pirela-Cruz MA
        • Goll SR
        • Klug M
        • Windler D.
        Stress computed tomography analysis of the distal radioulnar joint: a diagnostic tool for determining translational motion.
        J Hand Surg. 1991; 16A: 75-82