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Anatomical Features of Metacarpal Heads That Simulate Bone Erosions: Cadaveric Study Using Computed Tomography Scanning and Sectional Radiography

Canella Moraes Carmo, Clarissa do MD; Cruz, Gisele Portes MD; Trudell, Debra RA; Hughes, Tudor MD; Chung, Christine MD; Resnick, Donald MD

Journal of Computer Assisted Tomography: July-August 2009 - Volume 33 - Issue 4 - p 573-578
doi: 10.1097/RCT.0b013e3181885946
Musculoskeletal Imaging

Objective: The objective of this study was to demonstrate the anatomical features of metacarpal heads that can simulate bone erosions.

Materials and Methods: After performing computed tomography scanning of 6 cadaveric hand specimens, normal anatomy was identified; the maximum depth, height, and area of the osseous concavities in the ulnar, radial, and intersesamoid aspects of the metacarpal heads were measured. An average value was determined for each of the measurements of the 5 fingers, and statistical analysis was done.

Results: Three concavities were identified in the first metacarpal head (intersesamoid, ulnar, and radial) and 2 in the others fingers (ulnar and radial). All of them had sharp regular margins without sclerotic reaction. The measurements of these concavities were done.

Conclusions: We analyzed the normal osseous anatomy of the metacarpal heads. Knowledge of this normal anatomy enables the radiologist to differentiate normal concave regions from bone erosions that accompany a variety of synovial inflammatory diseases.

From the Department of Radiology, Veterans Affairs Hospital, University of California, San Diego, San Diego, CA.

Received for publication June 19, 2008; accepted July 24, 2008.

Reprints: Clarissa Canella Moraes do Carmo, MD, 5 Avenue Oscar Lambret, chambre 351, Lille, France, 59037 (e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.