The complex wrist joint is vulnerable to disease and trauma. The cost of medical intervention is relatively high (carpal-tunnel release procedures alone, exceed $2 billion per year). Timely early treatment may reduce the economic toll in lost productivity and workers' compensation. Medical intervention would be enhanced if alternative diagnostic techniques were available to detect and stage wrist pathology earlier than is possible with current technology. If new techniques were non-invasive, and able to provide more relevant information than that obtained by current techniques, additional humanitarian and economic advantages would accrue. Anatek, Inc. has developed software diagnostic aids in other medical areas, including the temporomandibular joint. The software is utilized in CT and MR post-scan data processing. Evaluation of the wrist requires more sophisticated software, specifically designed for this clinical application and capable of evaluating bone, joint-spaces, ligaments cartilage and median nerve morphology, and segmentation of cellular content from synovial fluid quantified data will be obtained for new, pertinent parameters. To increase MR resolution. a prototype MR wrist- coil will be further developed to yield very high field homogeneity in specific anatomic regions. Phase I will provide information concerning the requirements for image resolution. and whether both CT and MR imaging are needed for optimal output. Phase II will include development of software and coils to product standards and conduct a clinical study to evaluate the comparative clinical efficacy of the new diagnostic software.Proposed commercial application:The software would be marketed to specialists in orthopedics, imaging centers, radiology departments and sorts medicine unit which treat and diagnose thousands of patients each year with wrist pathology of different types. It would also provide a valuable tool for researchers and institutions engaged in development and evaluation of new procedures for treatment of wrist pathology. The market potential is enhanced by the generalizability of the product to other joints.National Institute of Arthritis and Muscoloskeletal and Skin Diseases (NIAMS)
