Carpal Kinematics in Madelung Deformity

Peymani, Abbas; Roo, Marieke G. A. de; Dobbe, Johannes G. G.; Streekstra, Geert J.; McCarroll, H. Relton; Strackee, Simon D.

doi:10.1016/j.jhsa.2020.11.016

Cited by 7 publications

(9 citation statements)

References 47 publications

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“…18 The result is an increased palmar tilt, one of the findings of Madelung-like deformity. 12,53 Although we cannot conclude that our participants had Madelung-like deformity, it has been reported that lunate extension is decreased in Madelung deformity compared with that in healthy individuals, 41 which is consistent with our pain group results. The reason lunate extension did not decrease, even though an increase in palmar tilt was also observed in the painless group, is assumed to be that only the pain group showed an abnormal lunate position at 0° of wrist extension compared with the control group.…”

Section: Discussionsupporting

confidence: 90%

Abnormal Wrist Sagittal Kinematics in Gymnasts With Dorsal Wrist Pain: A New Syndrome

Sekiguchi,

Saito,

Ogura

et al. 2024

Am J Sports Med

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Background: The pathology of dorsal wrist pain in gymnasts without abnormal radiographic findings remains unclear. Purpose/Hypothesis: The purpose of this study was to identify abnormal wrist sagittal kinematics in gymnasts with dorsal wrist pain. It was hypothesized that gymnasts with dorsal wrist pain would show abnormal sagittal kinematics with reversible hypermobility of the intercarpal joint. Study Design: Controlled laboratory study. Methods: Participants included 19 wrists in male gymnasts with dorsal wrist pain, 18 wrist in male gymnasts without wrist pain, and 20 adult men without a history of wrist pain. Magnetic resonance imaging (T2-weighted sagittal images) findings at 0°, 30°, 60°, and 90° of wrist extension were used in kinematic analysis. The angles and translations of the radiolunate, capitolunate, and third carpometacarpal joint were measured and compared between the 3 groups. Results: At 90° of wrist extension, gymnasts with dorsal wrist pain had a significantly lower radiolunate joint angle (28.70°± 6.28° vs 36.19°± 7.81°; P = .020) and a significantly higher capitolunate joint angle (57.99°± 6.15° vs 50.50°± 6.98°; P = .004) and distal translation (1.17 ± 0.50 mm vs 0.46 ± 0.62 mm; P = .002) than gymnasts without dorsal wrist pain. Conclusion: Gymnasts with dorsal wrist pain showed abnormal wrist sagittal kinematics. These novel findings may facilitate understanding of dorsal wrist pain, which can be recognized as a new syndrome termed “gymnast’s lunate dyskinesia.”

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Section: Discussionsupporting

confidence: 90%

Abnormal Wrist Sagittal Kinematics in Gymnasts With Dorsal Wrist Pain: A New Syndrome

Sekiguchi,

Saito,

Ogura

et al. 2024

Am J Sports Med

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“…Dynamic evaluation of the minimum anteroposterior pisotriquetral interval and proximal/distal translation of the pisiform in relation to the triquetrum over 11 measurements proved helpful in detecting subtle PTI in each case, respectively. 30 Other wrist pathologies of the wrist investigated using 4DCT include the Madelung deformity, which involves decreased lunate and triquetral motion, 32 trigger lunate syndrome, consisting of cessation and subsequent catch-up of the lunate, 33 and Kienböck's disease, whereby disruption of blood supply results in lunate osteonecrosis. 34 To further establish the role of 4DCT in routine practice, several studies have been conducted to establish the normal range of motion of various small joints in the wrist according to predefined motions and 4DCT acquisition protocols.…”

Section: Wrist Imagingmentioning

confidence: 99%

“…Other wrist pathologies of the wrist investigated using 4DCT include the Madelung deformity, which involves decreased lunate and triquetral motion, 32 trigger lunate syndrome, consisting of cessation and subsequent catch-up of the lunate, 33 and Kienböck's disease, whereby disruption of blood supply results in lunate osteonecrosis 34 …”

Section: -Dimensional Ctmentioning

confidence: 99%

Computed Tomography

et al. 2022

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Although musculoskeletal magnetic resonance imaging (MRI) plays a dominant role in characterizing abnormalities, novel computed tomography (CT) techniques have found an emerging niche in several scenarios such as trauma, gout, and the characterization of pathologic biomechanical states during motion and weight-bearing. Recent developments and advancements in the field of musculoskeletal CT include 4-dimensional, cone-beam (CB), and dual-energy (DE) CT. Four-dimensional CT has the potential to quantify biomechanical derangements of peripheral joints in different joint positions to diagnose and characterize patellofemoral instability, scapholunate ligamentous injuries, and syndesmotic injuries. Cone-beam CT provides an opportunity to image peripheral joints during weight-bearing, augmenting the diagnosis and characterization of disease processes. Emerging CBCT technologies improved spatial resolution for osseous microstructures in the quantitative analysis of osteoarthritis-related subchondral bone changes, trauma, and fracture healing. Dual-energy CT–based material decomposition visualizes and quantifies monosodium urate crystals in gout, bone marrow edema in traumatic and nontraumatic fractures, and neoplastic disease. Recently, DE techniques have been applied to CBCT, contributing to increased image quality in contrast-enhanced arthrography, bone densitometry, and bone marrow imaging. This review describes 4-dimensional CT, CBCT, and DECT advances, current logistical limitations, and prospects for each technique.

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“…The irregular development of the volar-ulnar aspect of the distal radial epiphysis is responsible for Madelung’s deformity, which results in a shortened radius, dorsal displacement of the distal ulna, and a tapered row of carpal bones [ 2 – 4 ]. Patients may experience pain, reduced strength, and limited mobility [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of 3.0 Tesla magnetic resonance imaging in Madelung’s deformity: findings and implications

Ma,

Guo,

Wang

et al. 2024

BMC Musculoskelet Disord

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Objective The aim of the study was to investigate the 3.0 Tesla magnetic resonance imaging (MRI) features of Madelung’s deformity. Materials and methods The wrist MRI scans of 19 patients clinically diagnosed with Madelung’s deformity and 20 patients without deformity were consecutively selected from Beijing Jishuitan Hospital between April 2019 and December 2022 for observation, in the case group and control group, respectively. Multiple linear regression was used to analyze the factors affecting tilting angle and width of central disc (CD, also termed as triangular fibrocartilage, the main component of triangular fibrocartilage complex), while the chi-square test was used to compare the occurrences of CD (radial) attachment displacement, VL, and RTL. p < 0.05 indicated statistical significance. Results Madelung’s deformity significantly contributed to the tilting and thickening of the CD. In the case group, the tilting angle and thickness of CD were (51.46 ± 1.33)° and (0.23 ± 0.01) cm, respectively, which was statistically significant (p < 0.05); the radial attachment of the CD significantly shifted away from the distal articular surface level (χ2 = 39.00, p < 0.001), with a mean displacement of (0.97 ± 0.38) cm. Furthermore, the cases demonstrated abnormally developed Vickers ligament (χ2 = 35.19, p < 0.001) and radiotriquetral ligament (χ2 = 25.66, p < 0.001). Conclusion MRI provides a notable advantage in diagnosing Madelung’s deformity. Compared with the control group, patients with Madelung's deformity exhibited tilting and thickening of the CD. Additionally, the radial attachment of the CD was significantly shifted proximally with abnormal development of Vickers and radiotriquetral ligaments.

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Carpal Kinematics in Madelung Deformity

Cited by 7 publications

References 47 publications

Abnormal Wrist Sagittal Kinematics in Gymnasts With Dorsal Wrist Pain: A New Syndrome

Abnormal Wrist Sagittal Kinematics in Gymnasts With Dorsal Wrist Pain: A New Syndrome

Computed Tomography

Assessment of 3.0 Tesla magnetic resonance imaging in Madelung’s deformity: findings and implications

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