title: Assessment of pisotriquetral misalignment with magnetic resonance imaging: Is it associated with trauma?
abstract: OBJECTIVE
  Our objective was to determine whether there is an association between pisotriquetral (PT) malalignment and acute distal radius fracture by using magnetic resonance imaging (MRI).
  
  
  METHODS
  We evaluated 138 patients who underwent 3-T MRI of the wrists. Group A comprised 85 patients with acute distal radius fracture, and group B comprised 53 patients without trauma. PT interval and angle and pisiform excursion were measured on oblique axial and sagittal multiplanar reformats. The presence of abnormalities in the flexor carpi ulnaris tendon (FCU), pisometacarpal ligament (PML), and pisohamate ligament (PHL) were evaluated.
  
  
  RESULTS
  PT interval was wider in group A on both the axial and sagittal planes (P < 0.001). Axial PT angle opened more radially in group A (P < 0.001), and the absolute value of the sagittal PT angle in group A was wider than that in group B (P = 0.006). Abnormalities in FCU, PML, and PHL were more frequently observed in group A (P < 0.001). On multiple linear regression, distal radius fracture remained significant after adjusting for the patient's age and PT osteoarthritis.
  
  
  CONCLUSIONS
  Acute distal radius fracture can affect normal alignment of the PT joint, resulting in associated injuries to the primary PT joint stabilizers.
  
  
  CONCLUSIONS
  • Acute distal radius fracture is associated with malalignment of PT joints. • Acute distal radius fracture is associated with abnormalities of PT stabilizers. • PT joint alignment can be evaluated with MRI with 3D sequences. • Wrist MRI is useful for evaluating primary PT stabilizer injuries.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 110-744, Korea.
authors.forename: Hee-Dong
authors.initials: HD
authors.lastname: Chae
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 110-744, Korea. dalanara3@gmail.com.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Yoo
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 110-744, Korea.
authors.forename: Sung Hwan
authors.initials: SH
authors.lastname: Hong
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, 101, Daehak-Ro, Jongno-Gu, Seoul, 110-744, Korea.
authors.forename: Ja-Young
authors.initials: JY
authors.lastname: Choi
authors.affiliation: Department of Radiology, Seoul National University Bundang Hospital, 300 Gumidong, Bundang-Gu, Seongnam-City, Gyeongi-Do, 463-707, Korea.
authors.forename: Heung Sik
authors.initials: HS
authors.lastname: Kang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017760:Bone Malalignment / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011885:Radius Fractures / Q000150:complications / Q000175:diagnosis*; D014954:Wrist Injuries / Q000150:complications / Q000175:diagnosis*; D014955:Wrist Joint / Q000000981:diagnostic imaging*; D055815:Young Adult
keywords: Joint instability; Pisiform bone; Radius fractures; Triquetrum bone; Wrist Joint