Effect of elbow MRI with axial traction on articular cartilage visibility—a feasibility study

Kohyama, Sho; Tanaka, Toshikazu; Shimasaki, Koshiro; Kobayashi, Sayaka; Ikumi, Akira; Yanai, Takaji; Ochiai, Naoyuki

doi:10.1007/s00256-020-03455-3

Cited by 11 publications

(11 citation statements)

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“…Separating the articular cartilages of the femur and that of the tibia could allow better visualization of articular cartilage lesions. In the upper extremities, traction weights of 4 kg, 7 kg, and 4 kg in the shoulder, elbow, and wrist joints, respectively, have been reported to be safe and useful for detecting articular cartilage lesions [16,17,21]. As shown in this study, the articular cartilages of the femur and that of the tibia are usually in close contact.…”

Section: Discussionmentioning

confidence: 53%

Improving visualization of the articular cartilage of the knee with magnetic resonance imaging under axial traction: a comparative study of different traction weights

et al. 2021

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Objective Lesions of the articular cartilage of the knee, especially early grades, are not always accurately detected by magnetic resonance imaging (MRI) because of contact between the articular cartilage surfaces of the femur and the tibia. This study aimed to assess the effects of axial leg traction during knee MRI examination on joint space widening and articular cartilage visualization and evaluate the ideal weight for traction. Methods MRI was performed on ten healthy volunteers using a 3-T MRI unit with a 3D dual-echo steady-state gradientrecalled echo sequence. Conventional MRI was performed first, followed by traction MRI. The traction weight increased in the order of 5 kg, 10 kg, and 15 kg. Joint space widths were measured, and articular cartilage visualization was assessed at the medial and lateral tibiofemoral joints. Volunteers were asked to evaluate pain and discomfort using a visual analog scale during each procedure with axial traction to assess the safety of traction MRI. ResultsThe medial tibiofemoral joint space width significantly increased, and the visualization of the articular cartilage significantly improved by applying traction. The joint space width and the articular cartilage visualization showed no significant differences among traction weights of 5 kg, 10 kg, and 15 kg. Pain and discomfort during traction MRI examination were lowest with a traction weight of 5 kg. Conclusion Traction MRI examination may be useful in evaluating articular cartilage lesions at the medial tibiofemoral joint. A traction weight of 5 kg may be sufficient with minimum pain and discomfort.

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Section: Discussionmentioning

confidence: 53%

Improving visualization of the articular cartilage of the knee with magnetic resonance imaging under axial traction: a comparative study of different traction weights

et al. 2021

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“…In developing this technique, we intended to maximize the advantages and compensate for the shortcomings of MRI and CT. The application of axial traction widens the joint space of the radio-capitellar joint and improves visualization of the articular cartilage outline of the humeral capitellum with minimum pain and discomfort [ 30 , 31 ], making the creation of accurate 3D models of the articular cartilage possible, and enabling images with a slice thickness of 0.4 mm to be obtained using a 3D sequence. We used a 7 kg traction weight according to previous studies [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…The application of axial traction widens the joint space of the radio-capitellar joint and improves visualization of the articular cartilage outline of the humeral capitellum with minimum pain and discomfort [ 30 , 31 ], making the creation of accurate 3D models of the articular cartilage possible, and enabling images with a slice thickness of 0.4 mm to be obtained using a 3D sequence. We used a 7 kg traction weight according to previous studies [ 30 , 31 ]. There are no studies clarifying the ideal traction weight for elbow MRI in a skeletally immature population.…”

Section: Discussionmentioning

confidence: 99%

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Preoperative Evaluation and Surgical Simulation for Osteochondritis Dissecans of the Elbow Using Three-Dimensional MRI-CT Image Fusion Images

et al. 2021

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We used our novel three-dimensional magnetic resonance imaging-computed tomography fusion images (3D MRI-CT fusion images; MCFIs) for detailed preoperative lesion evaluation and surgical simulation in osteochondritis dissecans (OCD) of the elbow. Herein, we introduce our procedure and report the findings of the assessment of its utility. We enrolled 16 men (mean age: 14.0 years) and performed preoperative MRI using 7 kg axial traction with a 3-Tesla imager and CT. Three-dimensional-MRI models of the humerus and articular cartilage and a 3D-CT model of the humerus were constructed. We created MCFIs using both models. We validated the findings obtained from the MCFIs and intraoperative findings using the following items: articular cartilage fissures and defects, articular surface deformities, vertical and horizontal lesion diameters, the International Cartilage Repair Society (ICRS) classification, and surgical procedures. The MCFIs accurately reproduced the lesions and correctly matched the ICRS classification in 93.5% of cases. Surgery was performed as simulated in all cases. Preoperatively measured lesion diameters exhibited no significant differences compared to the intraoperative measurements. MCFIs were useful in the evaluation of OCD lesions and detailed preoperative surgical simulation through accurate reproduction of 3D structural details of the lesions.

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“…Therefore, to enhance the visibility of the articular cartilage, we have attempted to perform MRI while applying axial traction to the joint. This method of applying axial traction to improve visualization of articular cartilage has been previously used to observe other joints, including for osteochondritis dissecans in the capitellum [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of Magnetic Resonance Imaging With Axial Traction of the Thumb Carpometacarpal Joint on Articular Cartilage Visibility: A Feasibility Study

Ikumi¹,

Kohyama²,

Okuwaki³

et al. 2022

Cureus

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The objective of this study was to verify the usefulness of magnetic resonance imaging (MRI) with axial traction of the thumb for observing articular cartilage. Materials and methodsEleven healthy adult volunteers (39.7 ± 7.4 years) without thumb carpometacarpal joint arthritis or trauma were included in this study. A 3-tesla (3T) MRI (Magnetom Skyra, Siemens Healthineers AG, Munich, Germany) of the right thumb with axial traction applied by a finger trap with three traction weights (0, 2, and 5 kg) was performed. A 3D T2* multiecho data imaging combination (MEDIC) was selected to visualize the articular cartilage. After multiplanar reconstruction, sagittal and coronal images of the thumb carpometacarpal joint were used to evaluate the articular cartilage visibility and joint space widths at five locations. Articular cartilage visibility was evaluated using our original classification method that used the percentage of the cartilage detectable area. The Friedman test was used to compare the differences between each traction weight and location. ResultsArticular cartilage visibility significantly improved with axial traction. The average joint space widths with the 5-kg application were 1.9 ± 0.8, 3.9 ± 0.6, 2.0 ± 0.9, 3.9 ± 1.1, and 2.5 ± 1.4 mm at the center, volar edge, dorsal edge, radial edge, and ulnar edge, respectively. The joint space widths significantly increased proportionally with the traction weight at all locations. The joint space widths at the volar and radial edges were significantly greater than those at other locations. ConclusionApplying axial traction to the thumb increased the joint space widths and improved the visibility of the articular cartilage in the carpometacarpal joint on MRI.

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Effect of elbow MRI with axial traction on articular cartilage visibility—a feasibility study

Cited by 11 publications

References 50 publications

Improving visualization of the articular cartilage of the knee with magnetic resonance imaging under axial traction: a comparative study of different traction weights

Improving visualization of the articular cartilage of the knee with magnetic resonance imaging under axial traction: a comparative study of different traction weights

Preoperative Evaluation and Surgical Simulation for Osteochondritis Dissecans of the Elbow Using Three-Dimensional MRI-CT Image Fusion Images

Effects of Magnetic Resonance Imaging With Axial Traction of the Thumb Carpometacarpal Joint on Articular Cartilage Visibility: A Feasibility Study

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