Lunotriquetral联盟是腕骨联盟的最常见形式,其中月骨和三角骨化中心之间的软骨未能发生凋亡。本技术病例报告研究了一名无症状腕部和一名怀疑有远端尺尺关节损伤的腕部参与者的Minnaar类型不同的双侧子宫三支联盟的关节运动学。使用光子计数探测器CT扫描仪捕获前顶凸期间的静态和动态(四维)CT图像。计算了两个手腕中的心三支联盟和相邻骨骼之间的骨间邻近分布,以量化关节运动学。在抵抗性前旋期间,与腔三性联盟相邻的关节处的骨间接近度分布表明,无症状和受伤的手腕之间的正中和最小骨间接近度存在差异。从loootriquetral联盟改变运动学可能是尺侧腕部疼痛和不适的来源,限制运动的功能范围。本病例报告重点介绍了在腰间联合治疗中腕关节运动学的潜在改变,以及与尺侧腕关节疼痛的可能关联,突出解剖结构以在射线照相随访中进行检查。此外,该病例报告证明了使用光子计数探测器技术进行四维CT在评估不同腕关节解剖中的关节运动学的技术可行性。
Lunotriquetral coalitions are the most common form of carpal coalition wherein the cartilage between the lunate and triquetrum ossification centers failed to undergo apoptosis. This technical
case report examines the arthrokinematics of bilateral lunotriquetral coalitions with dissimilar Minnaar types in one participant with one asymptomatic wrist and one wrist with suspected distal radioulnar joint injury. Static and dynamic (four-dimensional) CT images during pronosupination were captured using a photon-counting detector CT scanner. Interosseous proximity distributions were calculated between the lunotriquetral coalition and adjacent bones in both wrists to quantify arthrokinematics. Interosseous proximity distributions at joints adjacent to the lunotriquetral coalition demonstrate differences in median and minimum interosseous proximities between the asymptomatic and injured wrists during resisted pronosupination. Altered kinematics from lunotriquetral coalitions may be a source of ulnar-sided wrist pain and discomfort, limiting the functional range of motion. This
case report highlights potential alterations to wrist arthrokinematics in the setting of lunotriquetral coalitions and possible associations with ulnar-sided wrist pain, highlighting anatomy to examine in radiographic follow-up. Furthermore, this
case report demonstrates the technical feasibility of four-dimensional CT using photon-counting detector technology in assessing arthrokinematics in the setting of variant wrist anatomy.