Carpal instability in rheumatoid wrists

• Published in: Rheumatology international Vol. 24; no. 1; pp. 34 - 36
• Main Authors: MURAMATSU, Keiichi, IHARA, Koichiro, TANAKA, Hiroshi, KAWAI, Shinya
• Format: Journal Article
• Language: English
• Published: Berlin Springer 2004; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Arthritis; Arthritis, Rheumatoid - diagnostic imaging; Arthritis, Rheumatoid - physiopathology; Biological and medical sciences; Carpal Bones - diagnostic imaging; Carpal Bones - physiopathology; Disease Progression; Diseases of the osteoarticular system; Female; Humans; Inflammatory joint diseases; Joint Instability - diagnostic imaging; Joint Instability - physiopathology; Ligaments - diagnostic imaging; Ligaments - physiopathology; Male; Medical sciences; Middle Aged; Radiography; Wrist Joint - diagnostic imaging; Wrist Joint - physiopathology; Immunopathology; Ligament; Diseases of the osteoarticular system; Rheumatology; Autoimmune disease; Inflammatory joint disease; Wrist; Chronic; Rheumatoid arthritis; Instability; Carpal instability; Carpal ligament; Larsen grading
• ISSN: 0172-8172; 1437-160X
• DOI: 10.1007/s00296-002-0276-x

This study was conducted to identify patterns of carpal instability in the rheumatoid wrist. One hundred patients with proven rheumatoid arthritis were randomly chosen, and posteroanterior and lateral radiographs of right wrists were taken. The most common isolated pattern was volar intercalated segmental instability, apparent in 16 wrists, while nine wrists had scapholunate dissociations. Larsen grading scores revealed a correlation between disease duration, carpal height ratio, and ulnar translocation index. In the early stages of disease, the scapholunate angle was significantly increased and the lunate rotated volarly due to loosening of the intrinsic carpal ligament. In later phases, the capitolunate angle significantly increased and the capitate rotated dorsally. Patterns of carpal instability in rheumatoid wrists seem to be complicated, involving combined laxity of the intrinsic and extrinsic carpal ligaments.