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European Radiology
Published in: European Radiology 7/2012

01-07-2012 | Musculoskeletal

High-resolution ultrasound evaluation of extrinsic wrist ligaments in patients affected by rheumatoid arthritis

Authors: Luca Maria Sconfienza, Enzo Silvestri, Marco Amedeo Cimmino

Published in: European Radiology | Issue 7/2012

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Abstract

Objectives

To evaluate the ultrasound features of the extrinsic wrist ligaments in rheumatoid arthritis (RA) patients in comparison with healthy volunteers.

Methods

Twenty-one consecutive patients affected by RA (12 men, 9 women; mean age 57 ± 14.6 years) were compared with 21 controls (12, 9; 54 ± 12.1, respectively). Wrists were evaluated using ultrasound on both palmar and dorsal sides along each ligament, using carpal bones as references. The following ligaments were studied: radioscaphocapitate, radiolunotriquetral, palmar ulnolunate, palmar ulnotriquetral, dorsal radiotriquetral, dorsal ulnotriquetral, and radial collateral ligament. Ligament number and thickness were noted. Echotexture was rated as fibrillar, fragmented, or heterogeneous; the surface was rated as smooth or blurred.

Results

The number of palmar ulnolunate and palmar ulnotriquetral ligaments detected by ultrasound in patients was significantly lower than in controls (P = 0.031 and P = 0.037, respectively). All ligaments had significantly more fragmented or heterogeneous echotexture and blurred surface and were significantly thinner in patients than in controls (P < 0.001). No correlation was found between ligament thickness and RA duration or clinical parameters.

Conclusions

Extrinsic wrist ligaments were less detectable and thinner in patients affected by RA compared with healthy volunteers matched for age and sex. Ligament thinning did not directly correlate with RA duration and clinical parameters.

Key Points

• Ultrasound is increasingly used to evaluate normal anatomy of extrinsic wrist ligaments.
• Extrinsic wrist ligaments are thinner in rheumatoid arthritis patients than in controls.
• Extrinsic wrist ligaments are less easy to detect in rheumatoid arthritis patients.
• Ligament thinning and detectability are not related to clinical parameters.
Literature
1.
2.
Sommer OJ, Kladosek A, Weiler V, Czembirek H, Boeck M, Stiskal M (2005) Rheumatoid arthritis: a practical guide to state-of-the-art imaging, image interpretation, and clinical implications. Radiographics 25:381–398PubMedCrossRef
3.
Narváez JA, Narváez J, De Lama E, De Albert M (2010) MR imaging of early rheumatoid arthritis. Radiographics 30:143–163PubMedCrossRef
4.
Toms AP, Chojnowski A, Cahir JG (2011) Midcarpal instability: a radiological perspective. Skeletal Radiol 40:533–541PubMedCrossRef
5.
Muramatsu K, Ihara K, Tanaka H, Kawai S (2004) Carpal instability in rheumatoid wrists. Rheumatol Int 24:34–36PubMedCrossRef
6.
Taljanovic MS, Goldberg MR, Sheppard JE, Rogers LF (2011) US of the intrinsic and extrinsic wrist ligaments and triangular fibrocartilage complex-normal anatomy and imaging technique. Radiographics 31:e44PubMedCrossRef
7.
Renoux J, Zeitoun-Eiss D, Brasseur JL (2009) Ultrasonographic study of wrist ligaments: review and new perspectives. Semin Musculoskelet Radiol 13:55–65PubMedCrossRef
8.
Tagliafico A, Rubino M, Autuori A, Bianchi S, Martinoli C (2007) Wrist and hand ultrasound. Semin Musculoskelet Radiol 11:95–104PubMedCrossRef
9.
Boutry N, Lapegue F, Masi L, Claret A, Demondion X, Cotten A (2005) Ultrasonographic evaluation of normal extrinsic and intrinsic carpal ligaments: preliminary experience. Skeletal Radiol 34:513–521PubMedCrossRef
10.
Lacelli F, Muda A, Sconfienza LM, Schettini D, Garlaschi G, Silvestri E (2008) High-resolution ultrasound anatomy of extrinsic carpal ligaments. Radiol Med 113:504–516PubMedCrossRef
11.
Taljanovic MS, Sheppard JE, Jones MD, Switlick DN, Hunter TB, Rogers LF (2008) Sonography and sonoarthrography of the scapholunate and lunotriquetral ligaments and TFC: initial experience and correlation with arthrography and magnetic resonance arthrography. J Ultrasound Med 27:179–191PubMed
12.
Arnett FC, Edworthy SM, Bloch DA et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324PubMedCrossRef
13.
Timins ME, Jahnke JP, Krah SF, Erickson SJ, Carrera GF (1995) MR imaging of the major carpal stabilizing ligaments: normal anatomy and clinical examples. Radiographics 15:575–587PubMed
14.
Graudal N (2004) The natural history and prognosis of rheumatoid arthritis: association of radiographic outcome with process variables, joint motion and immune proteins. Scand J Rheumatol Suppl 118:1–38PubMedCrossRef
15.
Kushner DM, Braunstein EM, Buckwalter KA, Krohn K, White HA (1993) Carpal instability in rheumatoid arthritis. Can Assoc Radiol J 44:291–295PubMed
16.
Viegas SF, Patterson RM, Ward K (1995) Extrinsic wrist ligaments in the pathomechanics of ulnar translation instability. J Hand Surg 20A:312–318
17.
Theumann NH, Pfirrmann CW, Antonio GE et al (2003) Extrinsic carpal ligaments: normal MR arthrographic appearance in cadavers. Radiology 226:171–179PubMedCrossRef
18.
Shahabpour M, De Maeseneer M, Pouders C et al (2011) MR imaging of normal extrinsic wrist ligaments using thin slices with clinical and surgical correlation. Eur J Radiol 77:196–201PubMedCrossRef
Metadata
Title
High-resolution ultrasound evaluation of extrinsic wrist ligaments in patients affected by rheumatoid arthritis
Authors
Luca Maria Sconfienza
Enzo Silvestri
Marco Amedeo Cimmino
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
European Radiology / Issue 7/2012
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2402-9

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