Physical Examination and Radiographic Staging of Thumb Carpometacarpal Arthritis

Zarb, Rakel M; Sasor, Sarah E.

doi:10.1016/j.hcl.2021.12.001

Cited by 4 publications

(5 citation statements)

References 28 publications

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“…Future work will validate the method for measurement of the healthy TMC JSW in-vivo using common radiographic hand orientations. 1 Validation of the method for measuring the in-vivo JSW of arthritic TMC joints would be performed in subsequent studies, providing quantitative correlates for qualitative joint space narrowing scores; such as those that have been developed for the finger joints using hand radiographs of patients with arthritis. 12,31,32 This study has several limitations.…”

Section: Discussionmentioning

confidence: 99%

“…The proposed measurement method of radiographic TMC JSW can be used to complement these qualitative measures by first providing a standardized means to measure the radiographic JSW of the healthy TMC joint. Future work will validate the method for measurement of the healthy TMC JSW in-vivo using common radiographic hand orientations 1 . Validation of the method for measuring the in-vivo JSW of arthritic TMC joints would be performed in subsequent studies, providing quantitative correlates for qualitative joint space narrowing scores; such as those that have been developed for the finger joints using hand radiographs of patients with arthritis 12 , 31 , 32 …”

Section: Discussionmentioning

confidence: 99%

“…The trapeziometacarpal (TMC) joint at the base of the thumb is defined by the articulation between the trapezium and first metacarpal. Plain radiography is commonly used to evaluate the joint with respect to the presence of common musculoskeletal disorders, 1 such as osteoarthritis, for which the TMC joint is the most commonly affected joint of the wrist 2 , 3 . Radiographic evaluation can be performed using established scoring systems, such as the Kellgren–Lawrence classification 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Structural degradation, such as joint space narrowing, can be included within the metrics of these scoring systems 5 . The use of specialized radiographic views generated from standardized hand orientations, in conjunction with prescribed beam angles, can highlight different articulations of the trapezium and aid in the joint evaluation; 1 however, the determination of quantifiable parameters can be challenging due to the spatial complexities of the two-dimensional radiographic projection of the three-dimensional joint when interpreted visually by an observer.…”

Section: Introductionmentioning

confidence: 99%

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Estimation of radiographic joint space of the trapeziometacarpal joint with computed tomographic validation

Jordan,

Elfar,

Kwoh

et al. 2024

J. Med. Imag.

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Joint space width (JSW) is a common metric used to evaluate joint structure on plain radiographs. For the hand, quantitative techniques are available for evaluation of the JSW of finger joints; however, such techniques have been difficult to establish for the trapeziometacarpal (TMC) joint. This study aimed to develop a validated method for measuring the radiographic joint space of the healthy TMC joint.Approach: Computed tomographic scans were taken of 15 cadaveric hands. The location of a JSW analysis region on the articular surface of the first metacarpal was established in 3D space and standardized in a 2D projection. The standardized region was applied to simulated radiographic images. A correction factor was defined as the ratio of the CT-based and radiograph-based joint space measurements. Leave-one-out validation was used to correct the radiograph-based measurements. A t-test was used to evaluate the difference between CT-based and corrected radiograph-based measurements (α ¼ 0.05). Results:The CT-based and radiograph-based measurements of JSW were 3.61 AE 0.72 mm and 2.18 AE 0.40 mm, respectively. The correction factor for radiograph-based joint space was 1.69 AE 0.41. Before correction, the difference between the CT-based and radiograph-based joint space was 1.43 mm [95% CI: 0.99 − 1.86 mm; p < 0.001]. After correction, the difference was −0.11 mm [95% CI: −0.63 − 0.41 mm; p ¼ 0.669].Conclusions: Corrected measurements of radiographic TMC JSW agreed well with CT-measured JSW. With in-vivo validation, the developed methodology has potential for automated and accurate radiographic measurement of TMC JSW.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Estimation of radiographic joint space of the trapeziometacarpal joint with computed tomographic validation

Jordan,

Elfar,

Kwoh

et al. 2024

J. Med. Imag.

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“…This classification is a staging protocol on four different stages based on synovitis, joint space, and capsule laxity (Figure 12). Some authors affirm that there is no direct correlation between the level of joint involvement and the patient's clinical condition [50,51]. Ribak et al find a correlation only in Eaton-Littler stages III and IV [37].…”

Section: Instrumental Evaluationmentioning

confidence: 99%

Rhizarthrosis Part I: A Literature Review

Colonna,

Borghi

2024

Cureus

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Rhizarthrosis (RA), or trapeziometacarpal osteoarthritis, is an arthritic degenerative process that affects the first joint of the thumb. The objective of this work is to provide therapists with an overview of the fundamental issues related to the therapeutic management of trapeziometacarpal joint instability.Prevalent in females, especially post-menopause, and linked to age, RA involves ligament and muscle structures, with causes ranging from hormonal influences to mechanical factors. Understanding the biomechanics, stability, and factors contributing to RA is crucial for effective intervention. This study explores the role of ligaments, muscles, and anatomical variants in thumb joint degeneration, emphasizing the importance of stability and congruence.RA manifests as pain at the base of the thumb, limiting grip strength and hindering everyday tasks. Pain initially occurs during specific movements but can progress to constant discomfort, affecting sleep. Chronic RA leads to joint stiffness, deformities like the "Z thumb," and muscle atrophy, impacting daily functions.Clinical evaluation involves pain assessment, joint mobility examination, and palpation. Diagnostic tests like the grind test and lever test aid in confirming RA. Radiographic examination reveals joint space degeneration and osteophytes and helps classify RA stages using the Eaton-Littler classification.Conservative treatment aims to alleviate pain, reduce joint stress, and enhance function. Orthoses help stabilize the joint. Therapeutic exercises, emphasizing muscle strength and dynamic stability, prove beneficial. Manual therapies like neurodynamic, Kaltenborn, Mulligan, and Maitland techniques target pain reduction and improve joint mechanics.The studies on conservative approaches provide evidence that a multimodal intervention consisting of joint mobilization, neural mobilization, and exercise is beneficial in reducing pain in patients with RA. When conservative therapy fails, surgical intervention is indicated.

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Oxygen-ozone therapy for pain relief in patients with trapeziometacarpal osteoarthritis: a proof-of-concept study

de Sire,

Marotta,

Sconza

et al. 2024

Disability and Rehabilitation

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Physical Examination and Radiographic Staging of Thumb Carpometacarpal Arthritis

Cited by 4 publications

References 28 publications

Estimation of radiographic joint space of the trapeziometacarpal joint with computed tomographic validation

Estimation of radiographic joint space of the trapeziometacarpal joint with computed tomographic validation

Rhizarthrosis Part I: A Literature Review

Oxygen-ozone therapy for pain relief in patients with trapeziometacarpal osteoarthritis: a proof-of-concept study

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