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DOI:10.2214/AJR.07.4010
AJR 2009; 192:W13-W19
© American Roentgen Ray Society


Original Research

Imaging the Ligaments of the Trapeziometacarpal Joint: MRI Compared with MR Arthrography in Cadaveric Specimens

Fabiano Nassar Cardoso1,2, Hyun-Jin Kim1,3, Flavio Albertotti1, Michael J. Botte4, Donald Resnick1 and Christine B. Chung1

1 Department of Radiology, University of California at San Diego and VA Healthcare System San Diego, 3350 La Jolla Village Dr., San Diego, CA 92161.
2 Department of Diagnostic Imaging, UNIFESP-EPM, Sao Paulo, Brazil.
3 Department of Radiology, Konyang University Hospital, Nonsan, Korea.
4 Department of Orthopaedic Surgery, University of California at San Diego and VA Healthcare System San Diego, San Diego, CA.

OBJECTIVE. The purpose of our study was to compare the normal ligamentous anatomy of the trapeziometacarpal joint in cadavers on conventional MRI and MR arthrography and review the most common diseases and abnormalities that affect this articulation.

MATERIALS AND METHODS. MR images of seven trapeziometacarpal joints of seven fresh cadaveric hands were obtained before and after arthrography. The MR appearances of the ligaments around the trapeziometacarpal joint were analyzed and correlated with corresponding anatomic sections. The imaging planes that allowed best analysis of these structures were determined.

RESULTS. Five ligaments around the trapeziometacarpal joint were generally recognized: the dorsoradial ligament; the posterior oblique ligament; the intermetacarpal ligament; the ulnar collateral ligament (UCL); and both portions of the anterior oblique ligament, the superficial anterior oblique and deep anterior oblique ligaments. The former three were attached to the dorsal aspect and the latter three to the volar aspect of the trapeziometacarpal joint. The dorsoradial ligament, posterior oblique ligament, intermetacarpal ligament, and superficial and deep anterior oblique ligaments were best visualized in the sagittal plane, whereas the UCL was best visualized in the coronal plane. MR arthrography mainly improved visualization of the intermetacarpal ligament, superficial and deep anterior oblique ligaments, and UCL.

CONCLUSION. MR arthrography improves visualization of and provides detailed information about the anatomy of the ligaments around the trapeziometacarpal joint. Knowledge of the appearance of these normal ligaments on MRI allows accurate diagnosis of lesions of the trapeziometacarpal ligaments and of the adjacent structures and aid the attending physician if and when surgery is indicated.

Keywords: hand anatomy • hand ligaments • MR arthrography • MRI • osteoarthritis • trapeziometacarpal joint • wrist anatomy


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