Abstract
A pisotriquetral (semilateral) view of the wrist may improve the assessment of pisotriquetral
osteoarthritis (OA), but its reliability and reproducibility are unclear. The purpose
of this cross-sectional observer study was to investigate (1) the inter- and intraobserver
agreement of evaluating pisotriquetral OA using pisotriquetral views with a special
focus on sclerosis, joint space width (JSW) narrowing and osteophyte formation, and
(2) the incidence of these latter radiographic features in patients suspected for
pisotriquetral OA. Five independent observers rated independently at two different
occasions 27 pisotriquetral views from patients treated for ulnar-sided wrist pain
suspected for pisotriquetral OA requiring a pisiform resection. The agreement was
calculated using kappa statistic. Agreement between observers ranged from 0.38 (fair)
to 0.56 (moderate). Average intraobserver agreement ranged from 0.43 (moderate) to
0.52 (moderate). In 36% of the ratings, JSW narrowing was observed, followed by osteophyte
formation (30%) and sclerosis (28%). Observers found it especially difficult to detect
JSW narrowing. Despite the availability of a pisotriquetral view to enhance visualization
of the pisotriquetral joint, assessment of the specific features indicating pisotriquetral
OA leads to only fair-to-moderate agreement. This limits the applicability of a radiographic
assessment. A rationale for a more reliable radiologic approach in assessing the level
of pisotriquetral OA is needed, which may require the use of more advanced imaging
techniques.
Keywords
pisiform - triquetral - pisotriquetral joint - pisotriquetral osteoarthritis - observer
