Carpal collapse in patients with rheumatoid arthritis

Inter- and Intraobserver Reliability of Three Different Methods Used for the Assessment of Carpal Collapse in Healthy Individuals

Introduction: Three different methods are described in the literature for the evaluation of carpal collapse. Measurements of carpal collapse by different people may affect the results. We aimed to investigate the inter and intraobserver reliability of three different methods used in carpal height measurement and to review the reference ranges for each method in healthy individuals. Methods: 179 wrist radiographs were evaluated by an orthopedist and a radiologist. Two observers made their evaluations independently of each other and unaware of each other's measurement results. They measured the carpal height ratio, the revised carpal height ratio, and the distance between the capitate-radius on each radiograph. One month later, all radiographs were reevaluated by two observers. Results: Results were analyzed by calculating the intraclass correlation coefficient. All methods had very high reproducibility. Interobserver reliability of the CH and RCH ratios were similar, and both had higher interobserver reliability scores than the CR index. In intraobserver reliability, the score of the CH ratio was higher in all measurements, and the lowest score was in the CR index. However, there was no statistical difference between the three methods in terms of inter- and intraobserver reliability. Conclusion: All three methods can be used in cases where the healthy extremity is desired to be used as a reference point in the evaluation of carpal height. Although the reliability scores of the CH ratio were found to be higher in this study, the practitioner can choose the desired method by evaluating the advantages and disadvantages of each method.

Gender differences in carpal height ratio in a taiwanese population

PURPOSE

To discover whether there is a significant difference in carpal height ratio (CHR) between men and women aged 20 to 50 years.

METHODS

We retrospectively reviewed 261 cases of normal plain wrist radiographs and measured the CHR using the Picture Achieving and Communication System. Each case was then stratified by gender and age (20-29, 30-39, and 40-50 y).

RESULTS

The mean CHR was 0.52 +/- 0.03 for men (range, 0.43-0.59), 0.50 +/- 0.03 for women (range, 0.43-0.57), and 0.51 +/- 0.03 for the total population (range, 0.43-0.59). The difference in CHR between men and women was statistically significant (p<.01). However, there was no significant difference (p=.13) among age groups in either men or women.

CONCLUSIONS

We recommend using gender-specific norms (ie, 0.52 +/- 0.03 for men and 0.50 +/- 0.03 for women, respectively) for CHR. Without gender specification, a subtle abnormality may be overlooked in men, and there may be an overdiagnosis of carpal disorder in women. Further investigations are needed to look into possible racial differences, because our study is based on a homogeneous ethnic Chinese population.