Pj. Weiler et Er. Bogoch, KINEMATICS OF THE DISTAL RADIOULNAR JOINT IN RHEUMATOID-ARTHRITIS - AN IN-VIVO STUDY USING CENTRODE ANALYSIS, The Journal of hand surgery, 20A(6), 1995, pp. 937-943
The kinematics of the distal radioulnar joint were examined using the
method of centrode analysis in vivo. A group of normal subjects was st
udied along with a group of rheumatoid arthritis patients who had dist
al radioulnar joint involvement. Serial computed tomographic scans wer
e obtained through the distal radioulnar joint of nine subjects (10 wr
ists) in varying degrees of pronation and supination. For normal subje
cts, the movement that occurs in a stable distal radioulnar joint is n
ot erratic and the center of rotation lies within a well-defined area.
When subjects with rheumatoid arthritis were analyzed, it was determi
ned that early in the disease process bone erosions may occur in the s
igmoid notch of the distal radius. When the joint contour in this regi
on is maintained, the kinematics are not markedly altered. Erosion inv
olving the dorsal border of the sigmoid notch of the radius is associa
ted with subluxation of the distal radioulnar joint. The ulna becomes
dorsally positioned relative to the radius, and significant alteration
in the kinematics of the distal radioulnar joint occurs.