Pisotriquetral joint: assessment with MR imaging and MR arthrography.
OBJECTIVE
To evaluate magnetic resonance (MR) imaging and MR arthrographic findings in the pisotriquetral joint (PTJ) and their contribution to assessment of PTJ osteoarthritis.


METHODS
Images of 22 fresh human cadaveric PTJs were obtained with both conventional and arthrographic MR techniques. The MR appearances of all intraarticular and periarticular structures were analyzed and correlated with anatomic slices. Two readers graded visibility of anatomic structures and severity of joint abnormalities. Differences in the visibility ratings at standard MR imaging and at MR arthrography were calculated. Association between the type of pisiform insertion of ligament or muscle with cartilaginous abnormalities of the PTJ was assessed. The association between cartilaginous lesions and osteoarthritic changes was calculated.


RESULTS
The tendon sheath, the fibrous capsule, and cartilaginous surfaces were better visualized at MR arthrography than at MR imaging. Pisohamate and pisometacarpal ligaments were slightly better seen on MR arthrograms. Tendons, muscles, and retinacular structures were well demonstrated at both conventional MR and MR arthrography. Cartilaginous lesions and osteophytes were easily identified and were detected more often in the pisiform bone than in the triquetral bone. Communication of the PTJ with the radiocarpal joint was noted in 18 (82%) of 22 wrists.


CONCLUSIONS
MR imaging and/or MR arthrography allows visualization of all anatomic structures of the PTJ. MR arthrography improves visualization of findings of osteoarthritis.
Theumann
Nicolas H
NH
Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr, San Diego, CA 92161, USA.
Pfirrmann
Christian W A
CW
Chung
Christine B
CB
Antonio
Gregory E
GE
Trudell
Debra J
DJ
Resnick
Donald
D
D000368:Aged; D000369:Aged, 80 and over; D002348:Carpal Bones / Q000033:anatomy & histology; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D008023:Ligaments, Articular / Q000033:anatomy & histology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013710:Tendons / Q000033:anatomy & histology; D014955:Wrist Joint / Q000033:anatomy & histology*