A new radiographic view of the scaphotrapeziotrapezoid joint: a cadaveric study

Arthur Turow, Joideep Phadnis, Gregory I. Bain

Research output: Contribution to journalArticle

Abstract

Background: The scaphotrapeziotrapezoid joint (STTJ) has a complex osseous and ligamentous anatomy. Precise radiographic assessment is paramount when assessing osteoarthritic, post-traumatic, or post-operative patients. There has been no described technique to image the STTJ without any wrist movement, unobscured by the rest of the carpus. The aim of this study was to define an optimal radiographic method to assess the STTJ while maintaining the wrist in neutral position. Methods: Computer tomography 3-D reconstructions of three uninjured wrists were initially used to determine an approximate beam angle. Serial radiographs of 12 cadaveric wrists were taken. The forearms were positioned in varying degrees of pronation and supination. The beam angle was concurrently adjusted to varying degrees of caudal tilt. From the images obtained, we assessed if the adjacent carpus obscured the view of the STTJ. Results: Optimal STTJ imaging was in the semi-pronated wrist position with the X-ray beam tilted caudal. We found that the STTJ was best visualized at 48° supination from a fully pronated wrist and a caudal beam angle of 22°. Conclusions: The described wrist and beam orientation can aid in achieving an unobstructed view of the STTJ with little technical effort. This can aid in imaging ambulatory patients where symptoms prevent using other imaging techniques as well as patients in the operating room where imaging timing can be critical.

Original languageEnglish
Pages (from-to)1899-1904
Number of pages6
JournalSkeletal Radiology
Volume48
Issue number12
DOIs
Publication statusPublished - Dec 2019

Keywords

  • Imaging
  • Scaphoid
  • Scaphotrapeziotrapezoid joint
  • STT joint
  • X-ray

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