Korean J Radiol.  2017 Dec;18(6):957-963. 10.3348/kjr.2017.18.6.957.

Anatomical Variants of Lister's Tubercle: A New Morphological Classification Based on Magnetic Resonance Imaging

• Chan WY
• Chong LR

• KMID: 2427205
• DOI: http://doi.org/10.3348/kjr.2017.18.6.957

Abstract

OBJECTIVE
Lister's tubercle is used as a standard anatomical landmark in hand surgery and arthroscopy procedures. In this study, we aimed to evaluate and propose a classification for anatomical variants of Lister's tubercle.
MATERIALS AND METHODS
Between September 2011 and July 2014, 360 MRI examinations for wrists performed using 1.5T scanners in a single institution were retrospectively evaluated. The prevalence of anatomical variants of Lister's tubercle based on the heights and morphology of its radial and ulnar peaks was assessed. These were classified into three distinct types: radial peak larger than ulnar peak (Type 1), similar radial and ulnar peaks (Type 2) and ulnar peak larger than radial peak (Type 3). Each type was further divided into 2 subtypes (A and B) based on the morphology of the peaks.
RESULTS
The proportions of Type 1, Type 2, and Type 3 variants in the study population were 69.2, 21.4, and 9.5%, respectively. For the subtypes, the Type 1A variant was the most common (41.4%) and conformed to the classical appearance of Lister's tubercle; whereas, Type 3A and 3B variants were rare configurations (6.4% and 3.1%, respectively) wherein the extensor pollicis longus tendon coursed along the radial aspect of Lister's tubercle.
CONCLUSION
Anatomical variations of Lister's tubercle have potential clinical implications for certain pathological conditions and pre-procedural planning. The proposed classification system facilitates a better understanding of these anatomical variations and easier identification of at-risk and rare variants.

Keyword

Lister's tubercle; Extensor pollicis longus; MR imaging; Anatomy

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Female
Humans
Image Processing, Computer-Assisted
*Magnetic Resonance Imaging
Male
Middle Aged
Retrospective Studies
Wrist/*anatomy & histology/diagnostic imaging
Young Adult

Figure

• 

  Fig. 1 Type 1 variant on diagrams and axial MR images.A. Schematic of Type 1 variant. B. Type 1A variant (classical configuration of Lister's tubercle). C. Type 1B variant wherein radial (r) peak is dominant with box-like configuration and ulnar peak (u) is small. ECRB = extensor carpi radialis brevis, ECRL = extensor carpi radialis longus, EPL = extensor pollicis longus

• 

  Fig. 2 Type 2 variant on diagrams and axial MR images.A. Schematic of Type 2 variant. B. Type 2A variant wherein both radial (r) and ulnar (u) peaks are discrete and equal in height. C. Type 2B variant wherein both radial (r) and ulnar (u) peaks are equal in height but rudimentary and difficult to visualize.

• 

  Fig. 3 Type 3 variant on diagrams and axial MR images.A. Schematic of Type 3 variant. B. Type 3A variant wherein the ulnar (u) peak is dominant and taller than radial (r) peak. C. Type 3B variant wherein ulnar (u) peak is dominant with absent radial (r) peak. In these variants, EPL tendon appears to cross radial to palpated Lister's tubercle.

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