ABSTRACT
PURPOSE: Increased joint laxity has been associated with the risk of ligament injury and development of osteoarthritis in large joints such as the knee, but this has not been investigated in depth in the hand. We hypothesized that generalized joint laxity would correlate with radiographic measures of trapeziometacarpal (TM) joint subluxation, as measured in carpometacarpal stress view radiographs. METHODS: We recruited volunteer subjects of all ages and examined them for generalized laxity using the Beighton-Horan index. A total of 163 subjects, 81 men and 82 women, with an average age of 48 years (range, 20-83 y), were examined. Each subject underwent a stress view radiograph of both TM joints using a previously described technique. Different examiners independently measured radial subluxation of the thumb metacarpal over the trapezium and the articular width of the thumb metacarpal and averaged them. The ratio of the radial subluxation to the articular width was calculated as a measure of radiographic TM laxity. RESULTS: The average Beighton score was 2 (range, 0-9). A total of 40 subjects had Beighton scores greater than 4. The mean stress view ratio was 0.31 (range, 0.06-0.58). When we calculated the Pearson correlation coefficient to assess the relationship between the stress view ratio and the Beighton score, a statistically significant correlation was demonstrated. CONCLUSIONS: In normal volunteers generalized joint laxity is positively correlated with increased mobility of the TM joint, as demonstrated on carpometacarpal stress view radiographs. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic I.
Subject(s)
Carpometacarpal Joints/diagnostic imaging , Joint Instability/complications , Joint Instability/diagnostic imaging , Joint Instability/etiology , Range of Motion, Articular/physiology , Adult , Age Factors , Aged , Aged, 80 and over , Carpometacarpal Joints/physiopathology , Cohort Studies , Disease Progression , Female , Humans , Male , Middle Aged , Multivariate Analysis , Orthopedic Procedures/methods , Osteoarthritis/diagnostic imaging , Osteoarthritis/etiology , Prospective Studies , Radiography , Regression Analysis , Risk Assessment , Severity of Illness Index , Sex Factors , Stress, Mechanical , Thumb/diagnostic imaging , Thumb/physiopathology , Trapezium Bone/diagnostic imaging , Trapezium Bone/physiopathology , Young AdultSubject(s)
Arm , Fistula/diagnosis , Histoplasmosis/complications , Humeral Head/pathology , Muscle, Skeletal/pathology , Muscular Diseases/diagnosis , Osteomyelitis/complications , Debridement/methods , Diagnosis, Differential , Female , Fistula/diagnostic imaging , Fistula/etiology , Histoplasma/isolation & purification , Histoplasmosis/diagnosis , Histoplasmosis/surgery , Humans , Humeral Head/microbiology , Humeral Head/surgery , Magnetic Resonance Imaging , Middle Aged , Muscle, Skeletal/surgery , Muscular Diseases/surgery , Osteomyelitis/diagnosis , Osteomyelitis/surgery , UltrasonographyABSTRACT
This article provides a brief review of the normal osseous, ligamentous, muscular, and neurovascular imaging anatomy of the elbow. Special attention is paid to the normal structures that may simulate pathology, as well as anatomical variants that may lead to pathology. This review will help clarify distinctions between normal anatomy and abnormal anatomy, as well as elucidate pathological consequences of a seemingly normal structure.
