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The Sensitivity of Carpal Bone Indices to Rotational Malpositioning

Summary: The Sensitivity of Carpal Bone
Indices to Rotational Malpositioning
Cassandra Robertson, MD, Randy E. Ellis, PhD, Tom Goetz, MD,
Wade Gofton, MD, Paul V. Fenton, MD, Carolyn F. Small, PhD,
David R. Pichora, MD, Kingston, Ontario, Canada
We investigated the dependence of 20 radiographic carpal measurements (carpal indices) on
rotational positioning errors in posteroanterior and lateral radiographs. The measurements
were made from "true perspective" digitally reconstructed radiographs created from computed
tomography data. Most posteroanterior indices were not affected by rotation. Carpal height,
carpal height ratio, revised carpal height ratio, capitate­radius distance, and carpal ulnar
translocation were particularly robust. Lateral-view indices involving the scaphoid were the
most sensitive to simulated malpositioning: radioscaphoid, scapholunate, and scaphocapitate
angles were reduced from 58°, 48°, and 56° at true lateral to 30°, 24°, and 34°, respectively,
at 20° external rotation. Observers were unable to estimate the degree of malpositioning
accurately in either view. Our results support use of the "scaphopisocapitate" criterion for
assessing correct positioning in lateral plain radiographs. (J Hand Surg 2002;27A:435­442.
Copyright © 2002 by the American Society for Surgery of the Hand.)
Key words: Carpal index; measurement; radiograph; wrist; digitally reconstructed radiograph;
radioscaphoid, scapholunate, and scaphocapitate angles.
Despite the availability of new imaging technolo-


Source: Abolmaesumi, Purang - School of Computing, Queen's University (Kingston)


Collections: Computer Technologies and Information Sciences