The Journal of Bone and Joint Surgery (American). 2008;90:145-153.
doi:10.2106/JBJS.F.01603
© 2008 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the activity for this article:
 CME 1: January, February, March 2008 (publication date April 4, 2008; expir...
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Park, M. J.
Right arrow Articles by Kim, J. P.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Park, M. J.
Right arrow Articles by Kim, J. P.
Related Collections
Right arrow Hand/Wrist
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?

Reliability and Normal Values of Various Computed Tomography Methods for Quantifying Distal Radioulnar Joint Translation

Min Jong Park, MD1 and Jong Pil Kim, MD2

1 Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, South Korea. E-mail address: mjp{at}smc.samsung.co.kr
2 Department of Orthopaedic Surgery, Dankook University College of Medicine, 16-5 Anseo-dong, Cheonan 330-715, South Korea

Investigation performed at the Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from Samsung Biomedical Research Institute. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

Background: Several techniques have been proposed to measure translation of the distal radioulnar joint on computed tomography scans, but the criteria for diagnosing abnormal subluxation have not been standardized. The aims of this study were to evaluate the reliability of the current methods and to derive normal population values with these methods.

Methods: Computed tomography scans of forty-five asymptomatic wrists were performed with the hand in supination, neutral, and pronation. Four methods for diagnosing subluxation of the distal radioulnar joint were used: the radioulnar line method; the epicenter method; the radioulnar ratio method; and the subluxation ratio method, which is a modification of the radioulnar line method that involves use of a line perpendicular to the sigmoid notch. Three observers measured all of the scans independently and repeated the measurements three months later to determine the interobserver and intraobserver reliability. All of the measurements for each subject were averaged, and the average was considered to be the normal value for that subject.

Results: Interobserver reliability was best (substantial to almost perfect) with use of the subluxation ratio method. The intraclass correlation coefficients showed substantial to almost perfect reliability of the radioulnar line method, substantial reliability of the radioulnar ratio method, and moderate to substantial reliability of the epicenter method. The intraobserver reliability of all methods was almost perfect. The radioulnar line and subluxation ratio methods always showed the ulnar head to be located outside of the dorsal line in pronation and outside of the volar line in supination. The normal epicenter values indicated that the center of rotation of the distal radioulnar joint fell in the middle half of the sigmoid notch in all positions. The normal ranges derived with the radioulnar ratio method demonstrated larger variation than originally reported.

Conclusions: This study suggests that the subluxation ratio method is the most useful technique for measuring translation of the distal radioulnar joint as a result of its reliability and simplicity. Substantial variations in normal values derived with the current methods should be considered in a computed tomography evaluation of the distal radioulnar joint in symptomatic patients.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 J Antimicrob ChemotherHome page
P.-H. Hsieh, K.-C. Huang, P.-C. Lee, and M. S. Lee
Two-stage revision of infected hip arthroplasty using an antibiotic-loaded spacer: retrospective comparison between short-term and prolonged antibiotic therapy
J. Antimicrob. Chemother., August 1, 2009; 64(2): 392 - 397.
[Abstract] [Full Text] [PDF]