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01-10-2014 | Scientific Article

Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions

Authors: Clemens Dumont, Sebastian Lerzer, Morad Ali Vafa, Mohammad Tezval, Peter Dechent, Klaus Michael Stürmer, Joachim Lotz

Published in: Skeletal Radiology | Issue 10/2014

Abstract

Objective

To assess ligament lesions and subluxations of the carpometacarpal joints of the thumbs (CMC I) of asymptomatic volunteers and of patients with CMC I osteoarthritis using advanced magnetic resonance imaging (MRI).

Materials and Methods

A total of 20 CMC I joints of 14 asymptomatic volunteers (6× both sides) and 28 CMC I joints of 22 patients (6× both sides) with symptomatic and X-ray-diagnosed osteoarthritis of CMC I joints were studied. During extension, flexion, abduction and adduction of the thumb, the anterior oblique (AOL), intermetacarpal (IML), posterior oblique (POL) and dorsal radial (DRL) ligaments were evaluated using 3-T MRI on two standard planes, and translation of metacarpal I (MC I) was assessed.

Results

The MRI demonstrated that ligament lesions of the AOL and IML are frequent. Isolated rupture of the AOL was found in 6 of 28 (21 %), combined rupture of the AOL + IML in 5 of 28 (18 %) and isolated IML rupture in 4 of 28 (14 %) joints.

The patients had a significantly increased dorsal translation of MC I during extension with a median of 6.4 mm vs. 5.4 mm in asymptomatic volunteers (p < 0.05).

Conclusion

MRIs of CMC I in two standardized planes frequently show combined ligament ruptures. The dorsal subluxation of MC I, which is increased in patients, correlates with OA severity based on X-ray and can be quantified by MRI. For joint-preserving surgical procedures and for prosthesis implantation of the CMC I, we recommend performing an MRI in two planes of the thumb—extension and abduction—to evaluate the ligaments and dorsal subluxation of MC I.

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Title: Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions
Authors: Clemens Dumont
Sebastian Lerzer
Morad Ali Vafa
Mohammad Tezval
Peter Dechent
Klaus Michael Stürmer
Joachim Lotz
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: Skeletal Radiology / Issue 10/2014
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI: https://doi.org/10.1007/s00256-014-1955-x

At a glance: The STEP trials

Springer Medicine

Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions

Abstract

Objective

Materials and Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Materials and Methods

Results

Conclusion

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