TY - JOUR
T1 - Madelung's Deformity
T2 - Diagnostic Thresholds of Radiographic Measurements
AU - McCarroll, H. Relton
AU - James, Michelle
AU - Newmeyer, William L.
AU - Manske, Paul R.
PY - 2010/5
Y1 - 2010/5
N2 - Purpose: Although the x-ray changes of advanced Madelung's deformity are well described, little quantitative information exists on the subtle, early changes of the deformity. This study investigated the threshold of 4 radiographic measurements that predict a diagnosis of Madelung's deformity by experienced hand surgeons. Methods: Ulnar tilt, lunate subsidence, lunate fossa angle, and palmar carpal displacement were measured on x-rays of patients with Madelung's deformity. For each set of x-rays 4 opinions were available concerning a diagnosis of Madelung's deformity as based on the x-rays only. The 4 quantitative measurements were examined to determine a threshold value that predicts a unanimous diagnosis of Madelung's deformity. Results: The thresholds for the diagnosis of Madelung's deformity are: ulnar tilt of 33° or greater, lunate subsidence of 4 mm or more, lunate fossa angle of 40° or greater, and palmar carpal displacement of 20 mm or more. When any one of these measurements equaled or exceeded this threshold value, the raters were unanimous in establishing a diagnosis of Madelung's deformity. Conclusions: Threshold values of ulnar tilt, lunate subsidence, lunate fossa angle, and palmar carpal displacement for the diagnosis of Madelung's deformity are determined. Lunate fossa angle may prove especially useful in the diagnosis of early Madelung's deformity. Type of study/level of evidence: Diagnostic I.
AB - Purpose: Although the x-ray changes of advanced Madelung's deformity are well described, little quantitative information exists on the subtle, early changes of the deformity. This study investigated the threshold of 4 radiographic measurements that predict a diagnosis of Madelung's deformity by experienced hand surgeons. Methods: Ulnar tilt, lunate subsidence, lunate fossa angle, and palmar carpal displacement were measured on x-rays of patients with Madelung's deformity. For each set of x-rays 4 opinions were available concerning a diagnosis of Madelung's deformity as based on the x-rays only. The 4 quantitative measurements were examined to determine a threshold value that predicts a unanimous diagnosis of Madelung's deformity. Results: The thresholds for the diagnosis of Madelung's deformity are: ulnar tilt of 33° or greater, lunate subsidence of 4 mm or more, lunate fossa angle of 40° or greater, and palmar carpal displacement of 20 mm or more. When any one of these measurements equaled or exceeded this threshold value, the raters were unanimous in establishing a diagnosis of Madelung's deformity. Conclusions: Threshold values of ulnar tilt, lunate subsidence, lunate fossa angle, and palmar carpal displacement for the diagnosis of Madelung's deformity are determined. Lunate fossa angle may prove especially useful in the diagnosis of early Madelung's deformity. Type of study/level of evidence: Diagnostic I.
KW - deformity
KW - diagnosis
KW - Madelung
KW - threshold
KW - x-ray
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U2 - 10.1016/j.jhsa.2010.02.003
DO - 10.1016/j.jhsa.2010.02.003
M3 - Article
C2 - 20347533
AN - SCOPUS:77951654714
VL - 35
SP - 807
EP - 812
JO - The Hand
JF - The Hand
SN - 1753-1934
IS - 5
ER -