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Mitchell T, Hamilton N, Dean B, Rodgers S, Fowler-Davis S, McLean S. A scoping review to map evidence regarding key domains and questions in the management of non-traumatic wrist disorders. HAND THERAPY 2024; 29:3-20. [PMID: 38425437 PMCID: PMC10901165 DOI: 10.1177/17589983231219595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/21/2023] [Indexed: 03/02/2024]
Abstract
Introduction Non-traumatic wrist disorders (NTWD) are commonly encountered yet sparse resources exist to aid management. This study aimed to produce a literature map regarding diagnosis, management, pathways of care and outcome measures for NTWDs in the United Kingdom. Methods An interdisciplinary team of clinicians and academic researchers used Joanna Briggs Institute guidelines and the PRISMA ScR checklist in this scoping review. A mixed stakeholder group of patients and healthcare professionals identified 16 questions of importance to which the literature was mapped. An a-priori search strategy of both published and non-published material from five electronic databases and grey literature resources identified records. Two reviewers independently screened records for inclusion using explicit eligibility criteria with oversight from a third. Data extraction through narrative synthesis, charting and summary was performed independently by two reviewers. Results Of 185 studies meeting eligibility criteria, diagnoses of wrist pain, De Quervain's syndrome and ulna-sided pain were encountered most frequently, with uncontrolled non-randomised trial or cohort study being the most frequently used methodology. Diagnostic methods used included subjective questioning, self-reported pain, palpation and special tests. Best practice guidelines were found from three sources for two NTWD conditions. Seventeen types of conservative management, and 20 different patient-reported outcome measures were suggested for NTWD. Conclusion Substantial gaps in evidence exist in all parts of the patient journey for NTWD when mapped against an analytic framework (AF). Opportunities exist for future rigorous primary studies to address these gaps and the preliminary concerns about the quality of the literature regarding NTWD.
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Affiliation(s)
- Thomas Mitchell
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
| | - Nick Hamilton
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
| | - Ben Dean
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Sarah Rodgers
- The Hand Unit, Northern General Hospital, Sheffield, UK
| | | | - Sionnadh McLean
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
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Gitto S, Albano D, Serpi F, Spadafora P, Colombo R, Messina C, Aliprandi A, Sconfienza LM. Diagnostic performance of high-resolution ultrasound in the evaluation of intrinsic and extrinsic wrist ligaments after trauma. ULTRASCHALL IN DER MEDIZIN (STUTTGART, GERMANY : 1980) 2024; 45:54-60. [PMID: 37001562 DOI: 10.1055/a-2066-9230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE To investigate the role of ultrasound (US) in the evaluation of intrinsic and extrinsic ligaments of the wrist with magnetic resonance arthrography (MRA) as the reference standard. MATERIALS AND METHODS This prospective study included patients referred for MRA after wrist trauma. US examination was performed just before MRA. On the dorsal and palmar sides of the wrist, the intrinsic interosseus and midcarpal, extrinsic, and collateral ligaments were evaluated. MRA was performed on a 1.5-T unit. In the first 20 patients included, ligament thickness was independently assessed using US and MRA and thickness reproducibility was calculated. Ligament integrity was evaluated in all patients. RESULTS 38 patients (22 men, 16 women; mean age: 38 years) were included. Ligament thickness reproducibility ranged between 44% for the palmar ulnocapitate ligament and 71% for the palmar scaphotriquetral ligament. US had a sensitivity, specificity, positive and negative predictive values, and accuracy of 100% in the identification of tears of the palmar (n=8) and dorsal (n=3) bands of the scapholunate ligament and the ulnar collateral ligament (n=3). It had a sensitivity of 100%, specificity of 97%, positive predictive value of 50%, negative predictive value of 100%, and accuracy of 97% in the identification of tears of the palmar ulnolunate ligament (n=1). CONCLUSION Compared to MRA, US showed good reproducibility in the assessment of wrist ligament thickness and similar accuracy with respect to identifying tears of the scapholunate, palmar ulnolunate, and ulnar collateral ligaments.
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Affiliation(s)
- Salvatore Gitto
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Diagnostic and Interventional Radiology Unit, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - Domenico Albano
- Diagnostic and Interventional Radiology Unit, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - Francesca Serpi
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Pierino Spadafora
- Diagnostic and Interventional Radiology Unit, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - Roberta Colombo
- Diagnostic and Interventional Radiology Unit, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | - Carmelo Messina
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Diagnostic and Interventional Radiology Unit, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
| | | | - Luca Maria Sconfienza
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Diagnostic and Interventional Radiology Unit, IRCCS Galeazzi Orthopaedic Institute, Milan, Italy
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Sato K, Otake S, Takahashi G, Murakami K, Mimata Y, Doita M. Radiographic study of the distal ulna in rheumatoid arthritis with extensor digitorum communis ruptures. Mod Rheumatol 2023; 34:92-96. [PMID: 36408995 DOI: 10.1093/mr/roac139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/02/2022] [Accepted: 11/09/2022] [Indexed: 12/24/2023]
Abstract
OBJECTIVES Extensor digitorum communis (EDC) rupture of the wrist often occurs in patients with rheumatoid arthritis (RA). Early operation is desirable for patients with a high risk of rupture; therefore, rheumatologists should diagnose it during daily examinations. This study aimed to clarify radiographic changes in the distal ulna and related factors associated with EDC rupture in patients with RA. METHODS We analysed plain radiographs of 40 patients with RA associated with EDC rupture and 62 healthy controls. We investigated the deformation of the distal ulna, Larsen grades, and radiological parameters such as ulnar variance (UV), ulnar bowing angle, dorsal protrusion (DP), and dorsal bowing angle. RESULTS The ratios of the ulna head deformation, Larsen grades, UV, DP, and dorsal bowing angle were significantly larger in the ruptured group than in the control group. Multiple logistic regression analysis revealed that DP and Larsen grades were significantly associated with EDC rupture. CONCLUSIONS Deformity of the distal ulna is evident in patients with an EDC rupture. Ulnar head deformation, high Larsen grades, and large DP are the potential risk factors for EDC rupture.
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Affiliation(s)
- Kotaro Sato
- Department of Orthopaedic Surgery, Iwate Medical University, Shiwa-Gun, Iwate, Japan
| | - Shinpei Otake
- Department of Orthopaedic Surgery, Iwate Medical University, Shiwa-Gun, Iwate, Japan
| | - Gaku Takahashi
- Department of Critical Care Medicine, Iwate Medical University, Shiwa-Gun, Iwate, Japan
| | - Kenya Murakami
- Department of Orthopaedic Surgery, Iwate Medical University, Shiwa-Gun, Iwate, Japan
| | - Yoshikuni Mimata
- Department of Orthopaedic Surgery, Iwate Medical University, Shiwa-Gun, Iwate, Japan
| | - Minoru Doita
- Department of Orthopaedic Surgery, Iwate Medical University, Shiwa-Gun, Iwate, Japan
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Sudoł-Szopińska I, Herregods N, Doria AS, Taljanovic MS, Gietka P, Tzaribachev N, Klauser AS. Advances in Musculoskeletal Imaging in Juvenile Idiopathic Arthritis. Biomedicines 2022; 10:biomedicines10102417. [PMID: 36289680 PMCID: PMC9598961 DOI: 10.3390/biomedicines10102417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/11/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Over the past decade, imaging of inflammatory arthritis in juvenile arthropathies has significantly advanced due to technological improvements in the imaging modalities and elaboration of imaging recommendations and protocols through systematic international collaboration. This review presents the latest developments in ultrasound (US) and magnetic resonance imaging (MRI) of the peripheral and axial joints in juvenile idiopathic arthritis. In the field of US, the ultra-wideband and ultra-high-frequency transducers provide outstanding spatial resolution. The more sensitive Doppler options further improve the assessment and quantification of the vascularization of inflamed tissues, and shear wave elastography enables the diagnosis of tissue stiffness. Concerning MRI, substantial progress has been achieved due to technological improvements in combination with the development of semiquantitative scoring systems for the assessment of inflammation and the introduction of new definitions addressing the pediatric population. New solutions, such as superb microflow imaging, shear wave elastography, volume-interpolated breath-hold examination, and MRI-based synthetic computed tomography open new diagnostic possibilities and, at the same time, pose new challenges in terms of clinical applications and the interpretation of findings.
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Affiliation(s)
- Iwona Sudoł-Szopińska
- Department of Radiology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
- Correspondence:
| | - Nele Herregods
- Department of Radiology and Nuclear Medicine, Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium
| | - Andrea S. Doria
- Department of Diagnostic Imaging, The Hospital for Sick Children, University Avenue, Toronto, ON M5G 1X8, Canada
| | - Mihra S. Taljanovic
- Department of Medical Imaging and Orthopaedic Surgery, University of Arizona, Tucson, AZ 85719, USA
- Department of Radiology, University of New Mexico, Albuquerque, NM 87131, USA
| | - Piotr Gietka
- Clinic of Paediatric Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, 02-637 Warsaw, Poland
| | - Nikolay Tzaribachev
- Pediatric Rheumatology Research Institute, Achtern Dieck 7, 24576 Bad Bramstedt, Germany
| | - Andrea Sabine Klauser
- Rheumatology and Sports Imaging, Department of Radiology, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria
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Taljanovic MS, Omar IM, Weaver JS, Becker JL, Mercer DM, Becker GW. Posttreatment Imaging of the Wrist and Hand: Update 2022. Semin Musculoskelet Radiol 2022; 26:295-313. [PMID: 35654096 DOI: 10.1055/s-0042-1743538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Common indications for surgical procedures of the wrist and hand include acute fractures or fracture-dislocations; nonunited fractures; posttraumatic, degenerative, and inflammatory arthritides and tendinopathies; injuries to tendons, ligaments, and the triangular fibrocartilage complex; and entrapment neuropathies. Soft tissue or osseous infections or masses may also need surgical treatment. Several of these procedures require surgical hardware placement, and most entail clinical follow-up with periodic imaging. Radiography should be the first imaging modality in the evaluation of the postoperative wrist and hand. Computed tomography, magnetic resonance imaging, diagnostic ultrasonography, and occasionally nuclear medicine studies may be performed to diagnose or better characterize suspected postoperative complications. To provide adequate evaluation of postoperative imaging of the wrist and hand, the interpreting radiologist must be familiar with the basic principles of these surgical procedures and both the imaging appearance of normal postoperative findings as well as the potential complications.
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Affiliation(s)
- Mihra S Taljanovic
- Department of Medical Imaging, The University of Arizona, College of Medicine, Tucson, Arizona.,Department of Radiology, University of New Mexico, Albuquerque, New Mexico
| | - Imran M Omar
- Department of Radiology, Northwestern Memorial Hospital, Chicago, Illinois
| | - Jennifer S Weaver
- Department of Radiology, University of New Mexico, Albuquerque, New Mexico
| | - Jennifer L Becker
- Department of Medical Imaging, The University of Arizona, College of Medicine, Tucson, Arizona
| | - Deana M Mercer
- Department of Orthopaedics and Rehabilitation, University of New Mexico, Albuquerque, New Mexico
| | - Giles W Becker
- Department of Orthopaedic Surgery, University of Arizona, Tucson, Arizona
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