The peritrapezial view: New radiograph for evaluating joints around trapezium.

Abstract

The purpose of this study was to present a new radiograph of peritrapezial view and examine whether this view could supply clear and reliable radiographs of the joints around trapezium. The radiographs of peritrapezial and Robert views were taken on both hands of the 30 healthy volunteers (15 men and 15 women). The four peritrapezial joints were evaluated by two trained hand surgeons to find out whether these views could clearly show the joint spaces around the trapezium. Intra- and interobserver agreement for evaluation of each joint space and the ratio of joints which both of the two observers rated as clear joint space were compared between peritrapezial and Robert views. The κ values of inter- and intra-observer reliability were, respectively, 0.559 and 0.715 in peritrapezial view and 0.462 and 0.355 in Robert view. The ratios of joints, which both of the two observers rated as clear joint space in each of the two time evaluations, were slightly higher in peritrapezial view than Robert view for the thumb carpometacarpal (100% vs. 96.7%) and scaphoid-trapezium joints (100% vs. 93.3%). In addition, these ratios were significantly higher in peritrapezial view than Robert view for the trapezium-index metacarpal (90.0% vs. 46.7%, p < 0.001) and trapezium-trapezoid joints (93.3% vs. 50.0%, p < 0.001). The peritrapezial view clearly shows the joint spaces around the trapezium. This view showed better inter- and intra-observer reliability for peritrapezial joints than Robert view especially in trapezium-index metacarpal and trapezium-trapezoid joint. This radiograph could provide a preliminary step for evaluating and managing pathologies of the peritrapezial joints.