X-ray Of The Wrist Bone And Cartilage Structure, Organization Control Study And Clinical Significance

Based on 1) a correlative radiographic and histologic slab study of the wrists in 50 infants who died of unrelatde diseases and 6 normal adults who died in vehicle accidents, 2) a retrospective study of a large number of wrist radiographs including 70 normal subjects, 55 cases of RA, 203 cases of Kaschin-Beck's disease and 107 cases of skeletal fluorosis, and 3) a CT study of wrists of 30 RA cases, the authors'chief conclusions are as follows:1. With histological-appositional growth of bone, vessels at the top of Ranvier's groove are enclosed and changed into blood vessels adjacent to the layer of germinal cells in the epiphyseal as the growth processes go on.2. The locations of the partial convex parts of the provisional zone of calcification on the ra-diograph of the wrist are where the vessels in the epiphyseal cartilage are located.3. On wrist radiograph of the infant, bone bark in the Ranvier's groove may appear as a "thorn-like" bony process on margins of the metaphysis. This is not an abnormal sign.4. The germinal cells in epiphyseal cartilage may originate from the layer of flattened cells on the medial side of the bone bark.5. Various roentgen appearances of the provisional zone of calcification at the distal end of the radius and ulna are revealed on radiographs of the normal wrists. This precludes an abnormal diagnosis.6. The changes of carpal contour on infant radiographs coincided well with those of their his-tological development.7. The normal roentgen sign of the location of carpal ligament insertion may be identified on the wrist radiographs as bone plates becoming partially thinned, or irregular, or blurred, even disappearing.8. On the radiograph, the arrangement and distribution of normal carpal trabeculae are the same as those of trabeculae and vessels in the carpals revealed on histological slab : i. e. coarse and sparse at the center of the individual carpal bone, and fine and dense in the periphery. The direction of trabeculae and vessels is perpendicular to the subchondral bone plates.9. The surface of the lunate cartilage just opposite to the distal end of the radius is covered by fibrocartilage.10. This study further supports the point of view that vessels exist in the deeper layer of normal articular cartilage.11. The study of wrist radiographs of RA reveals that carpal erosions are predominantly visualized in the insertion of the radial collateral ligament of the scaphoid bone, and the midportion of the distal end of the radius, and the inferior radioulnar joint.12. The more severe Kaschin-Beck's disease is, the more opportunity the carpals have to be involved. Generally speaking, the capitatum and hamatum are frequently involved, if the disease...