Gilula three carpal arcs
Citation, DOI, disclosures and article data
At the time the article was created Umamaheswara Reddy V had no recorded disclosures.
View Umamaheswara Reddy V's current disclosuresAt the time the article was last revised Nico Behnke had no financial relationships to ineligible companies to disclose.
View Nico Behnke's current disclosures- Carpal arcs
- Three carpal arcs of Gilula
- Gilula's three carpal arcs
Gilula three carpal arcs are used in the assessment of the normal alignment of the carpus on PA wrist radiographs:
first arc: is a smooth curve outlining the proximal convexities of the scaphoid, lunate and triquetrum
second arc: traces the distal concave surfaces of the same bones
third arc: follows the main proximal curvatures of the capitate and hamate
Alignment
carpal bones have smooth and rounded edges to varying degrees, and lines joining these convexities form arcs; when major convexities are used in drawing
-
there should be no step-offs in the contour of the arcs, except for two normal variants 4
a triquetrum that is shorter in the proximal-distal dimension than the lunate creates a step-off in the first arc, but there is still a normal second arc
"bi-lobed" appearance of second carpal arc in lunate type II morphology because of a proximally prominent hamate
disrupted arc may indicate a ligamentous injury or fracture at the site of the broken arc
History and etymology
The concept of three radiographic arcs was first proposed by Louis A Gilula (1942-2014) in 1979 3,5.
References
- 1. Kaewlai R, Avery L, Asrani A, Abujudeh H, Sacknoff R, Novelline R. Multidetector CT of Carpal Injuries: Anatomy, Fractures, and Fracture-Dislocations. Radiographics. 2008;28(6):1771-84. doi:10.1148/rg.286085511 - Pubmed
- 2. Vezeridis P, Yoshioka H, Han R, Blazar P. Ulnar-Sided Wrist Pain. Part I: Anatomy and Physical Examination. Skeletal Radiol. 2009;39(8):733-45. doi:10.1007/s00256-009-0775-x - Pubmed
- 3. Gilula L. Carpal Injuries: Analytic Approach and Case Exercises. AJR Am J Roentgenol. 1979;133(3):503-17. doi:10.2214/ajr.133.3.503 - Pubmed
- 4. Loredo R, Sorge D, Garcia G. Radiographic Evaluation of the Wrist: A Vanishing Art. Semin Roentgenol. 2005;40(3):248-89. doi:10.1053/j.ro.2005.01.014 - Pubmed
- 5. Rubin D. Louis A. Gilula, MD. Radiology. 2015;274(1):308. doi:10.1148/radiol.14144047 - Pubmed
Incoming Links
- Disrupted Gilula arcs (anatomic variant)
- Bilateral pronator quadratus sign
- Scaphoid fracture
- Lunate dislocation
- Lunate dislocation
- Perilunate dislocation
- Lunate dislocation
- Gilula carpal arcs (diagram)
- 4th and 5th carpometacarpal joint dislocations
- Volar intercalated segmental instability (VISI)
- Scapholunate advanced collapse (SLAC)
- Gilula carpal arcs
- Scaphoid fracture - Mayo middle type
- Calcium pyrophosphate deposition arthropathy wrist
- Lunate avascular necrosis
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