Comparison of Magnetic Resonance Imaging and Radiographs for Evaluation of Carpal Osteoarthritis

Abstract

We sought to evaluate the interobserver and intraobserver reliability of radiographs and magnetic resonance imaging (MRI) for grading of osteoarthritis in patients with scapholunate advanced collapse (SLAC) and scaphoid nonunion advanced collapse (SNAC), and to determine whether MRI is more likely than radiographs to detect carpal osteoarthritis. Radiographs and MR studies of 46 patients with SLAC and SNAC arthritis were reviewed by two hand surgeons and two radiologists and were graded according to severity of osteoarthritis at seven carpal joints. Interobserver and intraobserver reliability was assessed using a weighted kappa analysis. Odds ratios were calculated to compare the likelihood of MRI versus radiographs in the determination of moderate or severe osteoarthritis. Measures of reliability were higher for MRI than radiographs. For radiographic assessment of all patients combined, interobserver agreement was moderate and intraobserver agreement was also moderate. For MRI, interobserver agreement was substantial and intraobserver agreement was almost perfect. In all joints combined for patients with SLAC and SNAC, MRI was 2.42 times more likely to demonstrate moderate osteoarthritis compared with radiographs. In patients with SLAC, MRI was 11.73 times more likely than radiographs to show moderate osteoarthritis at the radiolunate joint. In patients with SNAC, there was no difference in demonstration of moderate osteoarthritis on MRI compared with radiographs. Carpal osteoarthritis can be more reliably assessed on MRI than radiographs. MRI is more sensitive at demonstrating moderate changes of osteoarthritis than radiographs, especially at the radiolunate joint in patients with SLAC arthritis. This has implications for surgical management of SLAC/SNAC arthritis and preoperative planning. MRI should be included in the diagnostic workup and evaluation of patients with SLAC and SNAC arthritis. Diagnostic III.

Radial styloidectomy for scaphoid nonunion advanced collapse – relevance of nonunion location

“…Wrist MRI studies were blindly interpreted by a board-certified musculoskeletal MRI radiologist. The radioscaphoid joint was assessed using coronal and sagittal proton density sequences and graded according to a modified Outerbridge classification system (Li et al., 2017): grade 1, normal; grade 2, mild chondral wear (< 50% cartilage thickness); grade 3, deep chondral wear (> 50% cartilage thickness) up to full thickness chondral loss involving ≤ 25% of the scaphoid facet; grade 4, full thickness chondral loss involving ≥ 25% of the scaphoid facet. A joint was considered involved if the grade was ≥ 3.…”

Clinical applications of imaging modalities of the carpal joint in dogs with particular reference to the carpal canal

“…Radiological images are not an especially sensitive method for the evaluations of osteoarthritis of the wrist in humans. Assessment of carpal joints can be limited by overlapping structures because of the limb arrangement and projection (17).…”

“…MRI is an essential diagnostic tool in cases of chronic wrist pain in human patients, so much so that it has become the recommended method in the assessment of carpal osteoarthritis. MRI is better at revealing articular cartilage wastage and osteoarthritis changes than radiographs (17,44). The evaluation of wrist ligament integrity typically focuses on three ligamentous complexes: radiologists and clinicians in human medicine mostly assess the scapholunate ligament, lunotriquetral ligament, and the triangular fibrocartilage complex on MRI scans.…”

“…This article presents the use in practice of these techniques on canine patients. However, applications of imaging tools of carpal structures in dogs are not as well developed as in human medicine (17,19,25,26,30,34,44).…”

Frakturen des distalen Radius

“…Handwurzelinstabilitäten nach skapholunärer Dissoziation oder Kahnbeinfraktur können rasch zur Ausbildung eines SLAC-(Scapholunate advanced Collapse) bzw. SNAC-Handgelenks (Scaphoid Non-Union advanced Collapse) führen [20].…”