Clinical Rheumatology

, Volume 11, Issue 1, pp 101–104 | Cite as

Ulnar translation of the scaphoid: An early X-ray sign of rheumatoid arthritis

  • E. Avrahami
  • I. Wigler
  • F. Sperber
  • M. Yaron
Originals

Summary

The distance between the os trapezium and radius (which we called scaphoid distance) became shorter during the course of rheumatoid arthritis (RA). Measurement of this distance was performed in 600 hands (300 patients), using standard position of patient's hand in supination with permanent angle (15–20%) between the axis of the radius and the axis of the third metacarpal bone (scaphoid distance). This provided a stable distance between the most distal pont of the radial styloid process and most proximal point of the os trapezium. The patients were divided into two groups: a control group consisting of 100 patients with no inflammatory joint disease, and a group of 200 patients suffering from RA. Patients suffering from RA with bone erosions had smaller scaphoid distance than those suffering from RA without bone erosions. The ratio between the distance from the distal radius to the most distal point of the third metacarpal bone and scaphoid inded was called carpometacarpo-scaphoid index. It excluded the constitutional influence on the scaphoid distance. The short the scaphoid distance, the bigger the carpometacarpo-scaphoid index. The average indexes were: in the control group 7.8 (±0.4), in group 2A with advanced RA 21.1 (±4.1) and in group 2B with early RA without bone changes 12.0 (±1.6). The results were statistically significant. The measurements are easy to perform and may be helpful in the early X-ray diagnosis of RA, when there are not bone erosions, or narrowing of articular spaces.

Key words

Rheumatoid Arthritis Collagen Conventional Radiography Scaphoid Bone Hand 

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References

  1. 1.
    Committee of the American Rheumatism Association (Chairman Ropes MW). Diagnostic Criteria for Rheumatoid Arthritis: 1959 revision, Ann of Rheum Dis 1959, 18, 49–53.Google Scholar
  2. 2.
    Alarcon, G.S., Koopman, W.J. The carpometacarpal ratio: A useful method for assessing disease progression in rheumatoid arthritis. J Rheumatol 1985, 12, 846–848.Google Scholar
  3. 3.
    Brook, A., Corbett, M. Radiologic changes in early rheumatoid diseases. Ann Rheum Dis 1977, 36, 71–73.Google Scholar
  4. 4.
    Fletcher, M.D., Rowley, K.A. Radiologic feactures of rheumatoid arthritis. Br Med J 1977, 25, 282–295.Google Scholar
  5. 5.
    Martel, W. The pattern of rheumatoid arthritis in the hand and wrist. Radiol Clin North Am 1964, 2, 221–234.Google Scholar
  6. 6.
    Martel, W., Hayes, J.T., Duff, L.F. The pattern of bone erosions in the hand and wrist in rheumatoid arthritis. Radiology 1965, 84, 204–214.Google Scholar
  7. 7.
    Resnick, D. Rheumatoid arthritis of the wrist: The compartmental approach. Med Radiographic Photography, 1976, 52, 50–88.Google Scholar
  8. 8.
    Reunner, W.R., Weinstein, A.S. Early change sof rheumatoid arthritis in the hand and wrist. Radiol Clin North Am 1977, 26(6), 1185–1193.Google Scholar
  9. 9.
    Sharp, J.T., Weinstein, M.S. How many joints in the hand and wrist should be included in a score of radiologic abnormalities to assess rheumatoid arthritis? Arthritis Rheum 1985, 28, 1236–1335.Google Scholar
  10. 10.
    Trentham, D.E., Masi, A.T. Carpo: metacarpal ratio. A new quantiative mesure of radiologic progression of wrist involvement in the rheumatoid arthritis. Arthritis Rheum 1976, 19(5), 939–944.Google Scholar
  11. 11.
    Weston, W.C. Soft tissue changes of rheumatoid arthritis at the wrist. Aust Radiol 1962, 12, 384–392.Google Scholar

Copyright information

© Acta Medica Belgica 1992

Authors and Affiliations

  • E. Avrahami
    • 3
  • I. Wigler
    • 2
  • F. Sperber
    • 1
  • M. Yaron
    • 2
  1. 1.Department of RadiologyTel Aviv Medical Center, Inchilov HospitalIsrael
  2. 2.Department of RheumatologyTel Aviv Medical Center, Inchilov HospitalIsrael
  3. 3.Department of Radiology, Edith Wolfson Hospital and Sackler School of MedicineTel Aviv UniversityIsrael

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