title: Radiographic analysis of pisotriquetral joint and pisiform motion.
abstract: We evaluated 45 wrists of normal volunteers fluoroscopically (15) and radiographically (30) to determine the optimal radiographic technique for profiling the pisotriquetral (PT) joint and to assess the pisiform motion. Real-time fluoroscopy showed that 4 views are necessary for optimal PT joint and pisiform visualization: wrist neutral/30 degrees forearm supination, wrist extension/30 degrees forearm supination, and active plus passive wrist flexion/45 degrees forearm supination with thumb abduction. Excursion percentage of the PT articular surface apposition on video imaging occurred 10% proximally in neutral, 20% distally in extension, and 40% proximally in flexion. Radiography showed pisiform excursion distally (2.5 mm) in extension and proximally with active (3 mm) and passive (2 mm) flexion. Pisotriquetral angle opened proximally (15 degrees ) in extension and distally with active (10 degrees ) and passive (5 degrees ) flexion. Pisotriquetral space averaged 1.5 mm in neutral, 1 mm in extension, 3.5 mm in active, and 3 mm in passive flexion. Pisohamate distance averaged 7.5 mm in neutral, increased to 8 mm in extension, and decreased to 2 mm with active and 0 mm with passive flexion. These views and parameters are useful for evaluating patients with PT joint injury and disease.
authors.affiliation: Hand Surgery Section, Orthopedic Surgery Department, University of Oklahoma Medical School, and Integris Baptist Medical Center, Oklahoma City, OK 73112, USA.
authors.forename: Bretton H
authors.initials: BH
authors.lastname: Jameson
authors.forename: Ghazi M
authors.initials: GM
authors.lastname: Rayan
authors.forename: Robin E
authors.initials: RE
authors.lastname: Acker
mesh_terms: D002348:Carpal Bones / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000502:physiology*; D005471:Fluoroscopy; D006801:Humans; D008433:Mathematics; D016059:Range of Motion, Articular / Q000502:physiology*; D012016:Reference Values; D014741:Video Recording; D014955:Wrist Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging* / Q000502:physiology*