Abstract
Our understanding of wrist osteoarthritis (OA) lags behind that of other joints, possibly due to the complexity of wrist biomechanics and the importance of ligamentous forces in the function of the wrist. Scaphotrapeziotrapezoidal (STT) OA is common, but its role in wrist clinical pathology and biomechanics is unclear. We identified the prevalence of radiographic STT joint OA in our hand clinic population and defined the relationship between STT and radiocarpal OA in wrist radiographs. One hundred consecutive wrist clinical and radiographic exams were retrospectively reviewed. Radiographs were evaluated for the presence and stage of OA. The mean age was 61.3 (±14.5) years. The radiographic occurrence of STT joint OA was 59% and of radiocarpal (RC) OA was 29%. Radiographic STT and RC joint OA were inversely related. Tenderness over the STT joint in physical exam was not associated with OA in the STT or other joints. STT OA in our series was not related to wrist pain. These findings support the discrepancy between radiographic and cadaver findings and clinically significant OA in this joint. The inverse relationship between STT and RC OA, as seen in scapholunate advanced collapse (SLAC) wrist, requires further biomechanical study.
Highlights
The role that the scaphotrapeziotrapezoidal (STT) joint plays in the biomechanics of the wrist joint and thumb is still uncertain
Since the prevalence of clinical STT joint arthritis is estimated in some studies to be about 11%; it is possible that radiographs underestimate the actual occurrence of STT joint OA, and that most cases of STT OA are not clinically significant and remain undiagnosed [4]
We hypothesize that the true incidence of STT joint OA is more common than the 15% described radiologically in the literature, and that radiographic OA in this joint is inversely related to the occurrence of radiographic OA in the radioscaphoid (RS) joint [3]
Summary
The role that the scaphotrapeziotrapezoidal (STT) joint plays in the biomechanics of the wrist joint and thumb is still uncertain. The magnitude of clinically significant (tender, painful) STT OA has not been established. Since the prevalence of clinical STT joint arthritis is estimated in some studies to be about 11%; it is possible that radiographs underestimate the actual (cadaveric) occurrence of STT joint OA, and that most cases of STT OA are not clinically significant and remain undiagnosed [4]. The specific aims of this study were to identify the prevalence of radiographic STT joint OA in the population seen in our hand clinic and to define the relationship between OA in the STT and the radiocarpal joints on the wrist radiographs taken in our hand clinic. Secondary goals included evaluating the relationships between the different radiographic findings (STT OA, radiocarpal OA, thumb CMC joint OA, and measurement of the scapholunate gap) and between tenderness on physical examination and radiographic findings
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