Isolated scaphotrapeziotrapezoid osteoarthritis: prevalence, symptomatology and associated scapholunate ligament disruption in a population presenting to an accident and emergency department with acute wrist injuries.
OBJECTIVE
To determine the prevalence of isolated scaphotrapeziotrapezoid osteoarthritis in a population presenting to an Accident and Emergency Department of Leicester Royal Infirmary with acute wrist injuries. Also to identify the presence of scapholunate ligament disruption in this patient group and quantify symptoms and loss of function in terms of the modified system of Green and O'Brien, a recognized clinical scoring system.


METHODS
A total of 1711 radiographs of patients attending the Accident and Emergency Department were prospectively reviewed over a 5-month period. Those patients with isolated scaphotrapeziotrapezoid osteoarthritis were invited for clinical review.


RESULTS
Sixteen patients were identified with isolated scaphotrapeziotrapezoid osteoarthritis. Two had a poor Green and O'Brien score and evidence of scapholunate ligament disruption (P < 0.05).


CONCLUSIONS
Isolated scaphotrapeziotrapezoid osteoarthritis has a prevalence of 1% in a population presenting to an Accident and Emergency Department with acute wrist injuries over the age of 30 years. Isolated scaphotrapeziotrapezoid osteoarthritis may be asymptomatic even though the changes in the joint are severe. Scapholunate ligament disruption is associated with a poor Green and O'Brien score, but is not present in the majority of cases. Higginson, A. P.et al. (2001). Clinical Radiology56, 372-374.
Higginson
A P
AP
Department of Radiology, Leicester Royal Infirmary, Leicester LE1 5WW, U.K. Tony.Higgy@talk21.com
Braybrook
J
J
Williams
S
S
Finlay
D
D
D000208:Acute Disease; D000328:Adult; D000368:Aged; D004636:Emergency Service, Hospital; D005260:Female; D018737:Hand Strength; D006801:Humans; D008023:Ligaments, Articular / Q000503:physiopathology*; D012667:Lunate Bone; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D010147:Pain Measurement; D016059:Range of Motion, Articular; D021361:Scaphoid Bone; D012737:Sex Factors; D014954:Wrist Injuries / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D014955:Wrist Joint / Q000503:physiopathology*