Citation, DOI, disclosures and article data
Citation:
Knipe H, Eaton-Littler classification of thumb carpometacarpal joint osteoarthritis. Reference article, Radiopaedia.org (Accessed on 13 Mar 2025) https://doi.org/10.53347/rID-206823
Disclosures:
At the time the article was created Henry Knipe had the following disclosures:
- Micro-X Ltd, Shareholder (past)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Henry Knipe's current disclosures
Disclosures:
At the time the article was last revised Henry Knipe had the following disclosures:
- Micro-X Ltd, Shareholder (past)
These were assessed during peer review and were determined to
not be relevant to the changes that were made.
View Henry Knipe's current disclosures
The Eaton-Littler classification is used for the radiographic staging of thumb carpometacarpal (CMC) joint osteoarthritis (OA).
The Eaton-Littler classification is one of the most widely used systems (c. 2016) for staging thumb CMC osteoarthritis 1,2. This classification was first published in 1973 and was modified in 1987 to include triscaphe joint osteoarthritis 1,2.
This classification is limited by difficulty obtaining a true lateral thumb radiograph, poor-to-moderate intra- and inter-observer reliability, and an inconsistent relationship to clinical symptoms and intra-operative findings 1-3. Thus, its use to guide treatment is limited, although it may be useful in describing progressive disease 1,2.
The joint is evaluated on a true lateral thumb radiograph 1,2:
stage I: subtle CMC joint space widening (attributed to synovitis, effusion, or ligamentous laxity)
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stage II
slight CMC joint space narrowing, sclerosis, and/or cystic changes with osteophytes or loose bodies <2mm
less than one-third joint subluxation
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stage III
advanced CMC joint space narrowing, sclerosis, and cystic changes with osteophytes or loose bodies >2mm
more than one-third joint subluxation
stage IV: stage III + triscaphe osteoarthritis
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1. Kennedy C, Manske M, Huang J. Classifications in Brief: The Eaton-Littler Classification of Thumb Carpometacarpal Joint Arthrosis. Clin Orthop Relat Res. 2016;474(12):2729-33. doi:10.1007/s11999-016-4864-6 - Pubmed
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2. Melville D, Taljanovic M, Scalcione L et al. Imaging and Management of Thumb Carpometacarpal Joint Osteoarthritis. Skeletal Radiol. 2014;44(2):165-77. doi:10.1007/s00256-014-1997-0 - Pubmed
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3. Berger A, Momeni A, Ladd A. Intra- and Interobserver Reliability of the Eaton Classification for Trapeziometacarpal Arthritis: A Systematic Review. Clin Orthop Relat Res. 2014;472(4):1155-9. doi:10.1007/s11999-013-3208-z - Pubmed
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