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Related Experiment Videos

Carpal instability in rheumatoid arthritis

D M Kushner1, E M Braunstein, K A Buckwalter

  • 1Department of Radiology, University of Rochester, NY.

Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes
|August 1, 1993
PubMed
Summary

Carpal instability is common in rheumatoid arthritis, affecting 19 of 52 patients. Radiographs revealed various instability patterns, often linked to active erosions and joint changes.

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Area of Science:

  • Rheumatology
  • Orthopedics
  • Radiology

Background:

  • Rheumatoid arthritis (RA) frequently leads to mechanical complications affecting the wrist.
  • Carpal instability is a recognized but often underdiagnosed complication in RA patients.

Purpose of the Study:

  • To prospectively evaluate the prevalence and patterns of carpal instability in patients with rheumatoid arthritis.
  • To identify associations between carpal instability and radiographic findings in RA.

Main Methods:

  • Prospective examination of 52 patients diagnosed with rheumatoid arthritis.
  • Acquisition of posteroanterior, lateral, and oblique radiographs of both wrists.
  • Analysis of radiographic findings to identify patterns of carpal instability.

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Main Results:

  • Nineteen out of 52 patients (36.5%) exhibited one or more patterns of carpal instability.
  • The most frequent isolated pattern was volar intercalated segmental instability (VISI), seen in 6 patients.
  • Instability was more prevalent in patients with active erosions or distal radioulnar joint changes.

Conclusions:

  • Carpal instability is a common mechanical complication in rheumatoid arthritis.
  • Radiographic assessment is crucial for diagnosing carpal instability promptly.
  • Early diagnosis facilitates appropriate clinical management for RA patients with wrist involvement.