Comparing radial styloid size between osteoarthritic and healthy wrists: a pathoanatomical three-dimensional study.
Radial styloid pointing due to spur formation is considered an early sign of osteoarthritis, but is sometimes difficult to distinguish from normal anatomic variation. In this pathoanatomical study we used three-dimensional imaging techniques to evaluate quantitatively whether the styloid size is larger in wrists with scaphoid non-union than in healthy wrists. We compared these findings with duration of the non-union and with the scaphoid non-union advanced collapse classification, which was based on radiographic assessment of the general level of wrist osteoarthritis. In 31 patients, the injured styloid was consistently larger than the contralateral healthy styloid. In 74% of the patients this pathoanatomical difference (maximum 5 mm) exceeded anatomical left-to-right variation in styloid size (maximum 2 mm), indicating significant pointing. Increased styloid pointing was associated with older non-unions, and with more severe osteoarthritis. Three-dimensional styloid pointing analysis is an objective method to assess osteoarthritic progression. Combining traditional qualitative evaluation and quantitative measurements may improve the classification of wrist osteoarthritis.


METHODS
IV.
1 Department of Plastic, Reconstructive, and Hand Surgery, University of Amsterdam, Amsterdam, The Netherlands.
P W L
PWL
Ten Berg
2 Department of Biomedical Engineering and Physics, University of Amsterdam, Amsterdam, The Netherlands.
J G G
JGG
Dobbe
3 Department of Plastic, Reconstructive, and Hand Surgery, University Medical Center Rotterdam, Rotterdam, The Netherlands.
M E
ME
Brinkhorst
1 Department of Plastic, Reconstructive, and Hand Surgery, University of Amsterdam, Amsterdam, The Netherlands.
S D
SD
Strackee
2 Department of Biomedical Engineering and Physics, University of Amsterdam, Amsterdam, The Netherlands.|4 Department of Radiology, University of Amsterdam, Amsterdam, The Netherlands.
G J
GJ
Streekstra
Wrist; osteoarthritis; radial styloid; scaphoid; scaphoid non-union advanced collapse