Degenerative joint disease of the trapezium: a comparative radiographic and anatomic study

The accuracy of radiographic evaluation of the pantrapezial joints and the anatomic incidence of pantrapezial arthrosis, were studied by comparing radiographs with anatomic dissections of 68 cadaver hands. When the trapezium-thumb metacarpal joint demonstrated degenerative changes, multitrapezial joint changes were noted in 73% radiographically, but in only 46% anatomically. The major reason for this discrepancy was a radiographic misinterpretation of the nature of osteophytes near the trapezium-index metacarpal joint. Anatomic changes of degenerative joint disease were noted in 60% of the trapezium-thumb metacarpal joints and 34% of the trapezium-scaphoid joints. Degenerative joint changes were rare in the trapezium-index metacarpal and trapezium-trapezoid joints. Routine anteroposterior, lateral, and oblique radiographs of the hand cannot be depended upon to provide adequate visualization of all the trapezial joints.