Download PDF
Semin Musculoskelet Radiol 2001; 05(3): 235-240
DOI: 10.1055/s-2001-17546
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Wrist MRI and Carpal Instability: What the Surgeon Needs to Know, and the Case for Dynamic Imaging

Richard J. Miller
  • Department of Orthopaedics, University of Rochester Medical Center, Rochester, NY
Further Information

Publication History

Publication Date:
01 October 2001 (online)

Also available at
    Permissions and Reprints

ABSTRACT

The common clinical problem of carpal instability is often difficult to diagnose with the precision necessary to confidently direct appropriate treatment. The role of magnetic resonance imaging (MRI) in the evaluation of carpal instabilities is evolving but remains problematic. Finding solutions to these problems is contingent upon both the imaging specialist and clinician appreciating the full scope and clinical implications of the mechanical and kinematic complexity inherent in the anatomic design of the carpus. Providing specifics about the clinical questions that arise with various carpal instabilities serves to highlight the challenges facing current imaging technology, and provides a framework that supports the argument for the development of dynamic MRI as one-and perhaps the only-truly satisfactory solution to this problem.

KEYWORD

Magnetic resonant imaging - wrist - carpal - instability - kinematics - biomechanics - injury

REFERENCES

  • 1 Hobby J L, Tom B D, Bearcroft P W, Dixon A K. Magnetic resonance imaging of the wrist: diagnostic performance statistics.  Clin Radiol . 2001;  56 50-57
    CrossrefPubMedGoogle Scholar
  • 2 Dobyns J H, Linscheid R L. A short history of the wrist joint.  Hand Clin . 1997;  13 1-12
    PubMedGoogle Scholar
  • 3 Taleisnik J. Current concepts review: carpal instability.  J Bone Joint Surg (Am) . 1988;  70 1262-1268
    PubMedGoogle Scholar
  • 4 Kobayashi M, Berger R A, Linscheid R L, An K N. Intercarpal kinematics during wrist motion.  Hand Clin . 1997;  13 143-149
    PubMedGoogle Scholar
  • 5 Ruby L K, Cooney W P, An K N, Linscheid R L, Chao E Y. Relative motion of selected carpal bones: a kinematic analysis of the normal wrist.  J Hand Surg (Am) . 1988;  13 1-10
    CrossrefPubMedGoogle Scholar
  • 6 Ruby L K. Wrist biomechanics.  Instr Course Lect . 1992;  41 25-32
    PubMedGoogle Scholar
  • 7 Patterson R M, Nicodemus C L, Viegas S F, Elder K W, Rosenblatt J. High speed, three-dimensional kinematic analysis of the normal wrist.  J Hand Surg (Am) . 1998;  23 446-453
    PubMedGoogle Scholar
  • 8 Weber E R. Concepts governing the rotational shift of the intercalated segment of the carpus.  Orthop Clin North Am . 1984;  15 193-207
    PubMedGoogle Scholar
  • 9 Youm Y, Flatt A E. Kinematics of the wrist.  Clin Orthop . 1980;  149 21-32
    PubMedGoogle Scholar
  • 10 Kobayashi M, Berger R A, Nagy L. Normal kinematics of carpal bones: a three-dimensional analysis of carpal bone motion relative to the radius.  J Biomech . 1997;  30 787-793
    CrossrefPubMedGoogle Scholar
  • 11 Ruby L K, An K N, Linscheid R L, Cooney III W, Chao E Y. The effect of scapholunate ligament section on scapholunate motion.  J Hand Surg (Am) . 1987;  12 767-771
    PubMedGoogle Scholar
  • 12 Ritt M J, Linscheid R L, Cooney W P, Berger R A, An K N. The lunotriquetral joint: kinematic effects of sequential ligament sectioning, ligament repair, and arthrodesis.  J Hand Surg (Am) . 1998;  23 432-445
    PubMedGoogle Scholar
  • 13 Ritt M J, Bishop A T, Berger R A, Linscheid R L, Berglund L J, An K N. Lunotriquetral ligament properties: a comparison of three anatomic subregions.  J Hand Surg (Am) . 1998;  23 425-431
    PubMedGoogle Scholar
  • 14 Berger R A. Radial-sided carpal instability.  Instr Course Lect . 1998;  47 219-28
    PubMedGoogle Scholar
  • 15 Berger R A. The ligaments of the wrist: a current overview of anatomy with considerations of their potential functions.  Hand Clin . 1997;  13 63-82
    PubMedGoogle Scholar
  • 16 Burgess R C. The effect of rotatory subluxation of the scaphoid on radio scaphoid contact.  J Hand Surg (Am) . 1987;  12 771-774
    PubMedGoogle Scholar
  • 17 Linscheid R L, Dobyns J H, Beckenbaugh R D, Cooney W P, Woo. Instability patterns of the wrist.  J Hand Surg (Am) . 1983;  8 682-686
    PubMedGoogle Scholar
  • 18 Horii E, Garcia-Elias M, An K N. A kinematic study of luno triquetral dissociations.  J Hand Surg (Am) . 1991;  16 355-362
    PubMedGoogle Scholar
  • 19 Ruby L K. Carpal instability.  Instr Course Lect . 1996;  45 3-13
    PubMedGoogle Scholar
  • 20 Mayfield J K. Patterns of injury to carpal ligaments: a spectrum.  ClinOrthop . 1984;  Jul-Aug 36-4221
    PubMedGoogle Scholar
  • 21 Cooney W P, Linscheid R L, Dobyns J H. Carpal instability: treatment of ligament injuries of the wrist.  Instr Course Lect . 1992;  41 33-44
    PubMedGoogle Scholar
  • 22 Johnstone D J, Thorogood S, Smith W H, Scott T D. A comparison of magnetic resonance imaging and arthroscopy in the investigation of chronic wrist pain.  J Hand Surg (Br) . 1997;  22 714-718
    PubMedGoogle Scholar
  • 23 Viegas S F, Ballantyne G. Attritional lesions of the wrist joint.  J Hand Surg (Am) . 1987;  12 1025-1029
    PubMedGoogle Scholar
  • 24 Viegas S F, Patterson R M, Hokanson J A, Davis J. Wrist anatomy: incidence, distribution, and correlation of anatomic variations, tears, and arthrosis.  J Hand Surg (Am) . 1993;  18 463-475
    PubMedGoogle Scholar
  • 25 Oneson S R, Scales L M, Timins M E, Erickson S J, Chamoy L. MR imaging interpretation of the Palmer classification of triangular fibrocartilage complex lesions.  RadioGraphics . 1996;  16 97-106
    PubMedGoogle Scholar
  • 26 Oneson S R, Timins M E, Scales L M, Erickson S J, Chamoy L. MR imaging diagnosis of triangular fibrocartilage pathology with arthroscopic correlation.  Am J Roentgenol . 1997;  168 1513-1518
    PubMedGoogle Scholar
  • 27 Palmer A K. Triangular fibrocartilage complex lesions: a classification.  J Hand Surg (Am) . 1989;  14 594-606
    PubMedGoogle Scholar
      >