Gilula three carpal arcs

Last revised by Henry Knipe on 20 Apr 2024

Citation, DOI, disclosures and article data

Citation:

V U, Knipe H, Behnke N, et al. Gilula three carpal arcs. Reference article, Radiopaedia.org (Accessed on 20 Apr 2024) https://doi.org/10.53347/rID-25518

DOI:

https://doi.org/10.53347/rID-25518

Permalink:

https://radiopaedia.org/articles/25518

rID:

25518

Article created:

28 Oct 2013, Umamaheswara Reddy V

Disclosures:

At the time the article was created Umamaheswara Reddy V had no recorded disclosures.

View Umamaheswara Reddy V's current disclosures

Last revised:

20 Apr 2024, Henry Knipe ◉ ◈

Disclosures:

At the time the article was last revised Henry Knipe had the following disclosures:

Integral Diagnostics, Shareholder (ongoing)
Micro-X Ltd, Shareholder (ongoing)

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

Revisions:

25 times, by 15 contributors - see full revision history and disclosures

Systems:

Musculoskeletal, Trauma

Sections:

Approach

Tags:

cases

Synonyms:

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