The Effect of Axial Traction MRI on the Articular Cartilage Visibility in Thumb Carpometacarpal Arthritis

Akira Ikumi; Yuichi Yoshii; Sho Kohyama; Sho Iwabuchi; Takeo Mammoto; Takeshi Ogawa; Masashi Yamazaki

doi:10.7759/cureus.52025

The Effect of Axial Traction MRI on the Articular Cartilage Visibility in Thumb Carpometacarpal Arthritis

Cureus. 2024 Jan 10;16(1):e52025. doi: 10.7759/cureus.52025. eCollection 2024 Jan.

Authors

Akira Ikumi^{1

2}, Yuichi Yoshii³, Sho Kohyama⁴, Sho Iwabuchi¹, Takeo Mammoto², Takeshi Ogawa⁵, Masashi Yamazaki¹

Affiliations

¹ Department of Orthopedic Surgery, Institute of Medicine, University of Tsukuba, Ibaraki, JPN.
² Department of Orthopedic Surgery and Sports Medicine, Tsukuba University Hospital Mito Kyodo General Hospital, Ibaraki, JPN.
³ Department of Orthopedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, JPN.
⁴ Department of Orthopedic Surgery, Kikkoman General Hospital, Chiba, JPN.
⁵ Department of Orthopedic Surgery, National Hospital Organization, Mito Medical Center, Ibaraki, JPN.

Abstract

Objectives: Thumb carpometacarpal arthritis has a high incidence. However, the degree of damage to the cartilage has not been accurately assessed. The purpose of this study was to examine the effects of axial traction of the thumb carpometacarpal joint during magnetic resonance imaging (MRI) on the visibility of articular cartilage in patients with thumb carpometacarpal arthritis and to evaluate the articular cartilage defect using MRI findings.

Materials and methods: Forty-four patients with thumb carpometacarpal arthritis (14 males, 30 females) and a mean age of 67.3±8.6 years were classified according to Eaton Stages 1, 2, 3, and 4 in 2, 14, 24, and 4 patients, respectively. Axial traction MRI was performed with and without traction (3 kg) using 3-Tesla MRI (Siemens Magnetom Skyra) with a 3D T2* multiecho data imaging combination. The effectiveness of traction was verified using the joint space width before and after traction at five points (central, volar, dorsal, radial, and ulnar margins) and the original articular cartilage outline visibility classification (poor, intermediate, complete). The rate of remaining cartilage on each joint surface was also evaluated. Statistical significance was set at p<0.05 in this study.

Results: Joint space width increased significantly at all points with traction (P<0.01). The grade of articular cartilage outline visibility significantly improved from seven intermediate and 37 poor cases to 15 complete, 23 intermediate, and six poor cases (P<0.01). Significantly more articular cartilage remained in Stages 1-2 compared with Stages 3-4 arthritis of both articular surfaces (P<0.01 in first metacarpal, P=0.01 in trapezium).

Conclusion: Axial traction of the thumb increased the joint space width and improved articular cartilage visibility in the thumb carpometacarpal joint. Our results suggested that axial traction MRI can be used for noninvasive evaluation of articular cartilage defects in patients with thumb carpometacarpal arthritis and aid in selecting the optimal surgical procedure.

Keywords: articular cartilage; axial traction; cartilage defect; magnetic resonance imaging; thumb carpometacarpal arthritis.

Grants and funding

This work was supported by the JA co-commissioned research business of the Japanese Association of Rural Medicine (grant No. 2022-5).