Author:
Raven Eric E.J.,van den Bekerom Michel P.J.,Beumer Annechien,van Dijk C. Niek
Abstract
Background:
This study was aimed at identifying the criteria for the diagnosis of Radiocarpal instability in
rheumatoid arthritis RA).
Methods:
The main databases were searched to identify studies describing the pathophysiology of Radiocarpal instability
in patients with RA. We focussed on the epidemiology, radiographic parameters, criteria for instability and on treatment
options. Results. In the search 108 articles were found, of these 12 studies were included for this review. Instability occurs
in at an average of 35.2% of the rheumatoid wrists. The instability was found between 8 and 13 years after onset of
rheumatoid arthritis. A strong correlation was found between instability, duration of RA and Larsen score. Several
radiographic methods were described to evaluate Radiocarpal instability in RA. Several treatment options for instability in
patients with RA are described. All with their own indications and limitations.
Conclusion:
OOn a standard AP radiograph deformity can be measured using the carpal height and the ulnar translation
index of Chamay. This gives an indication for instability. For describing the deterioration of the joints the Larsen score is
most used. If there are more radiographs in time the Simmen classification can be used. For real assessment of instability
dynamic radiographs are needed.
Level of Evidence:
Level IV.
Publisher
Bentham Science Publishers Ltd.
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