{"id":141,"date":"2019-02-07T04:05:48","date_gmt":"2019-02-07T04:05:48","guid":{"rendered":"http:\/\/limb.dev.scorchedmedia.com.au\/research\/?p=141"},"modified":"2019-02-28T04:06:05","modified_gmt":"2019-02-28T04:06:05","slug":"comparison-of-plain-x-rays-and-computed-tomography-for-assessing-distal-radioulnar-joint-inclination","status":"publish","type":"post","link":"http:\/\/www.upperlimb.com\/research\/comparison-of-plain-x-rays-and-computed-tomography-for-assessing-distal-radioulnar-joint-inclination\/","title":{"rendered":"Comparison of plain X-rays and computed tomography for assessing distal radioulnar joint inclination"},"content":{"rendered":"<p>Heiss-Dunlop W, Couzens GB, Peters SE, Gadd K, Di Masco L, and Ross M.<br \/>\n<strong>The Journal of Hand Surgery 2014; 39(12):2417-2423.<\/strong><br \/>\n<em>DOI: 10.1016\/j.jhsa.2014.08.006<\/em><\/p>\n<p><span style=\"text-decoration: underline;\">Purpose<\/span>: To compare the inclination of the distal radioulnar joint (DRUJ) on computed tomography (CT) and plain radiography (XR) in order to assess the effect of narrowing the range of inclination used in the original Tolat classification system to identify potentially problematic reverse oblique DRUJs.<br \/>\n<span style=\"text-decoration: underline;\">Methods<\/span>: Two independent investigators compared the angle of inclination and Tolat type on matched wrist XRs in the coronal plane and CTs of the same patients with normal DRUJs. The degree of agreement between XR and CT was determined. Inter- and intra-observer reliabilities were calculated. The prevalence of the 3 inclination types of the DRUJs using Tolat\u2019s definition was recorded. Their original quantitative definition of the parallel Tolat type 1 DRUJ included all DRUJs with a measured inclination of \u00b110\u00b0. We noted and compared the resultant changes in prevalence of the different DRUJ types after narrowing the inclination range to \u00b15\u00b0 and \u00b13\u00b0.<br \/>\n<span style=\"text-decoration: underline;\">Results<\/span>: Highly significant correlation between CT and XR measurements were found for both observers. Despite this, the limits of agreement between CT and XR in determining the sigmoid notch inclination was \u20139\u00b0 to 11\u00b0 (\u00b12\u00b0 standard deviations from the mean difference). When measured from the CTs and using Tolat\u2019s original algorithm, the prevalence of Tolat type 1 DRUJ was 47% (N = 34), type 2 was 51% (N = 37), and type 3 was 1% (N = 1). These percentages changed to 7% (N = 5) for type 1, 78% (N = 56) for type 2, and 15% (N = 11) for type 3 when applying narrower ranges of inclination.<br \/>\n<span style=\"text-decoration: underline;\">Conclusions<\/span>: Narrowing the range of sigmoid notch inclination that defines type 1 (parallel) DRUJs when using CT provided a more accurate representation of the morphological types. It revealed an increased number of potentially problematic type 3 DRUJs. However, the statistical limits of agreement between CT and XR suggested that high-resolution 3-dimensional imaging is required to apply the new algorithm.<br \/>\nType of study\/level of evidence: Diagnostic II.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Heiss-Dunlop W, Couzens GB, Peters SE, Gadd K, Di Masco L, and Ross M. The Journal of Hand Surgery 2014; 39(12):2417-2423. DOI: 10.1016\/j.jhsa.2014.08.006 Purpose: To compare the inclination of the distal radioulnar joint (DRUJ) on computed tomography (CT) and plain radiography (XR) in order to assess the effect of narrowing the range of inclination used [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-141","post","type-post","status-publish","format-standard","hentry","category-recent-publications"],"_links":{"self":[{"href":"http:\/\/www.upperlimb.com\/research\/wp-json\/wp\/v2\/posts\/141","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.upperlimb.com\/research\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.upperlimb.com\/research\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.upperlimb.com\/research\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/www.upperlimb.com\/research\/wp-json\/wp\/v2\/comments?post=141"}],"version-history":[{"count":1,"href":"http:\/\/www.upperlimb.com\/research\/wp-json\/wp\/v2\/posts\/141\/revisions"}],"predecessor-version":[{"id":142,"href":"http:\/\/www.upperlimb.com\/research\/wp-json\/wp\/v2\/posts\/141\/revisions\/142"}],"wp:attachment":[{"href":"http:\/\/www.upperlimb.com\/research\/wp-json\/wp\/v2\/media?parent=141"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.upperlimb.com\/research\/wp-json\/wp\/v2\/categories?post=141"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.upperlimb.com\/research\/wp-json\/wp\/v2\/tags?post=141"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}