Four-dimensional computed tomography detects dynamic three-dimensional pathologies of the wrist in patients with calcium pyrophosphate deposition disease
ObjectivesCrystal deposits in ligaments of the wrist are typical findings in patients with calcium pyrophosphate deposition (CPPD) disease. CPPD crystals trigger inflammation and ultimately result in ligament tears with scapholunate (SL) advanced collapse (SLAC). This study aimed to investigate carp...
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2023.1231667/full |
| _version_ | 1797754665262120960 |
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| author | Sevtap Tugce Ulas Sevtap Tugce Ulas Louise Pochandke Sarah Ohrndorf Torsten Diekhoff Torsten Diekhoff Katharina Ziegeler |
| author_facet | Sevtap Tugce Ulas Sevtap Tugce Ulas Louise Pochandke Sarah Ohrndorf Torsten Diekhoff Torsten Diekhoff Katharina Ziegeler |
| author_sort | Sevtap Tugce Ulas |
| collection | DOAJ |
| description | ObjectivesCrystal deposits in ligaments of the wrist are typical findings in patients with calcium pyrophosphate deposition (CPPD) disease. CPPD crystals trigger inflammation and ultimately result in ligament tears with scapholunate (SL) advanced collapse (SLAC). This study aimed to investigate carpal instabilities in patients with CPPD using four-dimensional computed tomography (4D-CT) of the wrist.MethodsThis IRB-approved prospective feasibility study investigated patients with CPPD of the hand. All patients underwent a static 3D-CT and two dynamic 4D-CT in ulnar- and radial abduction and in supination and pronation movements to analyze instabilities of the SL region and of the distal radioulnar joint (DRUJ). Two independent readers scored the images for the presence of SL ligament and triangular fibrocartilage complex (TFCC) calcifications. Furthermore, the readers assessed the dynamic images for SL and DRUJ instabilities. Descriptive analyses were performed. Inter-rater reliability was assessed using Cohen’s kappa (κ).ResultsNine patients were included. SL ligament calcifications and instabilities were found in all patients. Of these, dynamic SL instability was detected in 77.8% of the patients, while 22.2% had a SLAC wrist. TFCC calcifications were found in 87.5% of the patients. Four patients had DRUJ instability (50%). No patient showed DRUJ instability without the presence of TFCC calcifications. Agreement between readers for calcifications was excellent (κ = 1) and almost perfect (κ = 0.89) for instabilities.ConclusionThis study provides the first evidence of relevant dynamic carpal instability in CPPD patients using advanced imaging techniques with 4D-CT, offering unique insights into wrist biomechanics. |
| first_indexed | 2024-03-12T17:36:52Z |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-03-12T17:36:52Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-8f9c71cd7f8c4079a228981541f787312023-08-04T10:47:02ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2023-08-011010.3389/fmed.2023.12316671231667Four-dimensional computed tomography detects dynamic three-dimensional pathologies of the wrist in patients with calcium pyrophosphate deposition diseaseSevtap Tugce Ulas0Sevtap Tugce Ulas1Louise Pochandke2Sarah Ohrndorf3Torsten Diekhoff4Torsten Diekhoff5Katharina Ziegeler6Department of Radiology, Charité – Universitätsmedizin Berlin, Campus Mitte, Humboldt – Universität zu Berlin, Freie Universität Berlin, Berlin, GermanyBerlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, GermanyDepartment of Radiology, Charité – Universitätsmedizin Berlin, Campus Mitte, Humboldt – Universität zu Berlin, Freie Universität Berlin, Berlin, GermanyDepartment of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Campus Mitte, Humboldt – Universität zu Berlin, Freie Universität Berlin, Berlin, GermanyDepartment of Radiology, Charité – Universitätsmedizin Berlin, Campus Mitte, Humboldt – Universität zu Berlin, Freie Universität Berlin, Berlin, GermanyBerlin Institute of Health at Charité – Universitätsmedizin Berlin, Berlin, GermanyDepartment of Radiology, Charité – Universitätsmedizin Berlin, Campus Mitte, Humboldt – Universität zu Berlin, Freie Universität Berlin, Berlin, GermanyObjectivesCrystal deposits in ligaments of the wrist are typical findings in patients with calcium pyrophosphate deposition (CPPD) disease. CPPD crystals trigger inflammation and ultimately result in ligament tears with scapholunate (SL) advanced collapse (SLAC). This study aimed to investigate carpal instabilities in patients with CPPD using four-dimensional computed tomography (4D-CT) of the wrist.MethodsThis IRB-approved prospective feasibility study investigated patients with CPPD of the hand. All patients underwent a static 3D-CT and two dynamic 4D-CT in ulnar- and radial abduction and in supination and pronation movements to analyze instabilities of the SL region and of the distal radioulnar joint (DRUJ). Two independent readers scored the images for the presence of SL ligament and triangular fibrocartilage complex (TFCC) calcifications. Furthermore, the readers assessed the dynamic images for SL and DRUJ instabilities. Descriptive analyses were performed. Inter-rater reliability was assessed using Cohen’s kappa (κ).ResultsNine patients were included. SL ligament calcifications and instabilities were found in all patients. Of these, dynamic SL instability was detected in 77.8% of the patients, while 22.2% had a SLAC wrist. TFCC calcifications were found in 87.5% of the patients. Four patients had DRUJ instability (50%). No patient showed DRUJ instability without the presence of TFCC calcifications. Agreement between readers for calcifications was excellent (κ = 1) and almost perfect (κ = 0.89) for instabilities.ConclusionThis study provides the first evidence of relevant dynamic carpal instability in CPPD patients using advanced imaging techniques with 4D-CT, offering unique insights into wrist biomechanics.https://www.frontiersin.org/articles/10.3389/fmed.2023.1231667/fullcomputed tomographyCPP diseasewrist4D-CTArthropathy |
| spellingShingle | Sevtap Tugce Ulas Sevtap Tugce Ulas Louise Pochandke Sarah Ohrndorf Torsten Diekhoff Torsten Diekhoff Katharina Ziegeler Four-dimensional computed tomography detects dynamic three-dimensional pathologies of the wrist in patients with calcium pyrophosphate deposition disease Frontiers in Medicine computed tomography CPP disease wrist 4D-CT Arthropathy |
| title | Four-dimensional computed tomography detects dynamic three-dimensional pathologies of the wrist in patients with calcium pyrophosphate deposition disease |
| title_full | Four-dimensional computed tomography detects dynamic three-dimensional pathologies of the wrist in patients with calcium pyrophosphate deposition disease |
| title_fullStr | Four-dimensional computed tomography detects dynamic three-dimensional pathologies of the wrist in patients with calcium pyrophosphate deposition disease |
| title_full_unstemmed | Four-dimensional computed tomography detects dynamic three-dimensional pathologies of the wrist in patients with calcium pyrophosphate deposition disease |
| title_short | Four-dimensional computed tomography detects dynamic three-dimensional pathologies of the wrist in patients with calcium pyrophosphate deposition disease |
| title_sort | four dimensional computed tomography detects dynamic three dimensional pathologies of the wrist in patients with calcium pyrophosphate deposition disease |
| topic | computed tomography CPP disease wrist 4D-CT Arthropathy |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2023.1231667/full |
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