Joint Instability, Wrist Injuries
Conditions
Brief summary
Compare various dynamic biomechanical markers (distances and angles) in the wrist during dynamic CT studies in three groups of patients: Normal subjects, with scapholunate instability and with other types of wrist instability.
Detailed description
Patients referred for the evaluation of wrist pain with CT arthrography will be eligible for inclusion. Patients will benefit from dynamic CT acquisitions before and after arthrography with three maneuvers: radio-ulnar deviation, clenching fist and dart throwing motion. Patients will also benefit from a wrist MR study on a 3 tesla scanner. The morphology of the carpal ligaments will be evaluated on static imaging (MR and CT arthrograph) and on dynamic CT arthrography. Distance and angular measurements will be obtained from dynamic CT studies using an appropriate post processing tool (4D-Ortho). Data obtained with dynamic wrist evaluation will be correlated to ligament morphology, classical wrist instability criteria on conventional radiographs and with surgery (if available).
Interventions
DEVICEDynamic CT
Various low dose CT acquisitions will be successively performed on the wrist to allow a four dimensional evaluation. The same type of acquisition will be performed during various manoeuvers (radio-ulnar deviation, clenching fist, and dart-throwing motion).
PROCEDUREArthrography
percutaneous intra-articular injection of contrast media in the medio-carpal and radio-carpal joints
Sponsors
Central Hospital, Nancy, France
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Clinical signs of wrist instability or wrist pain * Previous medical examination * Informed consent * Must have a social security number
Exclusion criteria
* MR or CT contra-indications * No prior surgery * Pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| scapholunate diastasis (mm) | 1 day | The distance between the scaphoid bone and the lunate bone will be measured during all maneuvers performed |
| Scapholunate angle | 1 day | the variation in the scapholunate angle during the maneuvers performed will be assessed |
| Lunocapitate angle | 1 day | the variation in the lunocapitate angle during the maneuvers performed will be assessed |
| Posterior radio scaphoid angle | 1 Day | The angle formed between the posterior most point of the scaphoid in the sagittal plane and the ventral and dorsal rims of the distal radius will be assessed |
Countries
France
Outcome results
None listed