1
|
Mitchell T, Hamilton N, Dean B, Rodgers S, Fowler-Davis S, McLean S. A scoping review to map evidence regarding key domains and questions in the management of non-traumatic wrist disorders. HAND THERAPY 2024; 29:3-20. [PMID: 38425437 PMCID: PMC10901165 DOI: 10.1177/17589983231219595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/21/2023] [Indexed: 03/02/2024]
Abstract
Introduction Non-traumatic wrist disorders (NTWD) are commonly encountered yet sparse resources exist to aid management. This study aimed to produce a literature map regarding diagnosis, management, pathways of care and outcome measures for NTWDs in the United Kingdom. Methods An interdisciplinary team of clinicians and academic researchers used Joanna Briggs Institute guidelines and the PRISMA ScR checklist in this scoping review. A mixed stakeholder group of patients and healthcare professionals identified 16 questions of importance to which the literature was mapped. An a-priori search strategy of both published and non-published material from five electronic databases and grey literature resources identified records. Two reviewers independently screened records for inclusion using explicit eligibility criteria with oversight from a third. Data extraction through narrative synthesis, charting and summary was performed independently by two reviewers. Results Of 185 studies meeting eligibility criteria, diagnoses of wrist pain, De Quervain's syndrome and ulna-sided pain were encountered most frequently, with uncontrolled non-randomised trial or cohort study being the most frequently used methodology. Diagnostic methods used included subjective questioning, self-reported pain, palpation and special tests. Best practice guidelines were found from three sources for two NTWD conditions. Seventeen types of conservative management, and 20 different patient-reported outcome measures were suggested for NTWD. Conclusion Substantial gaps in evidence exist in all parts of the patient journey for NTWD when mapped against an analytic framework (AF). Opportunities exist for future rigorous primary studies to address these gaps and the preliminary concerns about the quality of the literature regarding NTWD.
Collapse
Affiliation(s)
- Thomas Mitchell
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
| | - Nick Hamilton
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
| | - Ben Dean
- Nuffield Department of Clinical Neurosciences, University of Oxford, UK
| | - Sarah Rodgers
- The Hand Unit, Northern General Hospital, Sheffield, UK
| | | | - Sionnadh McLean
- Health Research Institute, Sheffield Hallam University, Sheffield, UK
| |
Collapse
|
2
|
Ng WHA, Griffith JF, Ng ISH. How to Report: Wrist MRI. Semin Musculoskelet Radiol 2021; 25:670-680. [PMID: 34861712 DOI: 10.1055/s-0041-1736313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Knowledge of the imaging anatomy of the wrist is essential for reporting magnetic resonance imaging (MRI). This familiarity should include the carpal bones, tendons (extensor and flexor compartments), triangular fibrocartilage complex (TFCC), intrinsic and extrinsic ligaments, and nerves, especially the median and ulnar nerves. Limitations of MRI in visualizing these structures, particularly the intrinsic ligaments and the TFCC, need to be considered. This article outlines the main features to comment on when reporting common conditions of the wrist on MRI, with some examples of terminology that can be used to describe these abnormalities.
Collapse
Affiliation(s)
- Wing Hung Alex Ng
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | - James Francis Griffith
- Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China
| | | |
Collapse
|
3
|
Sonographic imaging of hand and wrist injuries: applications in the ER setting. Emerg Radiol 2018; 26:227-240. [DOI: 10.1007/s10140-018-1649-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 09/26/2018] [Indexed: 01/14/2023]
|
4
|
Saranteas T, Igoumenou VG, Megaloikonomos PD, Mavrogenis AF. Ultrasonography in Trauma: Physics, Practice, and Training. JBJS Rev 2018; 6:e12. [PMID: 29688910 DOI: 10.2106/jbjs.rvw.17.00132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Theodosios Saranteas
- Second Department of Anesthesiology (T.S.) and First Department of Orthopaedics (V.G.I., P.D.M., and A.F.M.), National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece
| | | | | | | |
Collapse
|
5
|
US-guided percutaneous release of the first extensor tendon compartment using a 21-gauge needle in de Quervain's disease: a prospective study of 35 cases. Eur Radiol 2018; 28:3977-3985. [PMID: 29619521 DOI: 10.1007/s00330-018-5387-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/10/2018] [Accepted: 02/14/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE To evaluate the efficacy of ultrasonography-guided percutaneous treatment of de Quervain tenosynovitis with the combination of a corticosteroid injection and release of the retinaculum of the first extensor compartment tendons with a 21-gauge needle. MATERIALS AND METHODS The first part of our study consisted of ten procedures on cadaver wrists followed by dissection to analyse the effectiveness of the retinaculum release and detect any collateral damage. The second part was a prospective clinical study of 35 procedures. Outcomes were evaluated through a 6-month clinical follow-up and telephone interview at the end of the study. The following parameters were monitored over time: pain level on a visual analogue scale, the QuickDASH and the PRWE. Patient satisfaction questionnaires were also administered. RESULTS No complications were found during the cadaver study. However, the release was confirmed as 'partial' in all wrists. In the clinical portion of this study, significant improvement was observed in 91.4 % of cases (32/35) within 1 month and the results were stable until the end of the study; all of these patients avoided surgery. The release procedure failed in three patients who eventually required surgical treatment. CONCLUSION US-guided partial release and simultaneous corticosteroid injection for treatment of de Quervain's disease using a 21-gauge needle is feasible in current practice, with minimal complications. KEY POINTS • Ultrasound-guided treatment of de Quervain's disease is feasible with a 21G needle. • There was notable regression of clinical signs in 91.4 % of cases. • The procedure is very safe, no iatrogenic neurovascular or tendinous injuries occurred. • Our procedure requires only one session and 3 days away from work.
Collapse
|
6
|
Gitto S, Draghi AG, Draghi F. Sonography of Non-neoplastic Disorders of the Hand and Wrist Tendons. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:51-68. [PMID: 28708327 DOI: 10.1002/jum.14313] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/27/2017] [Accepted: 03/27/2017] [Indexed: 06/07/2023]
Abstract
Tendon disorders commonly cause hand and wrist disability and curtail the performance of work-related duties or routine tasks. Imaging is often needed for diagnosis, but it requires knowledge of the complex anatomic structures of the tendons of the hand and wrist as well as familiarity with related disorders. This review article aims to provide medical professionals with guidelines for the sonographic assessment of the tendons of hand and wrist and related disorders. Sonographic features of tendon disorders affecting the hand and wrist are described here, specifically: infectious tenosynovitis; tendon rupture or tearing; stenosing forms of tenosynovitis such as De Quervain disease and trigger finger; intersection syndrome; insertional tendinopathy; several forms of tendinous instability such as extensor carpi ulnaris instability, climber finger, and boxer knuckle; and tendinopathy in inflammatory rheumatic diseases. Postsurgical evaluation of the hand and wrist tendons is also discussed, including the healthy and pathologic appearances of operated tendons as well as impingement from orthopedic hardware. In conclusion, sonography is effective in assessing the tendons of the hand and wrist and related disorders and represents a valuable tool for diagnosis.
Collapse
Affiliation(s)
- Salvatore Gitto
- Postgraduate School in Radiodiagnostics, Università Degli Studi di Milano, Milan, Italy
| | - Anna Guja Draghi
- Radiology Institute, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Università Degli Studi di Pavia, Pavia, Italy
| | - Ferdinando Draghi
- Radiology Institute, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Università Degli Studi di Pavia, Pavia, Italy
| |
Collapse
|
7
|
Oguz AB, Polat O, Eneyli MG, Gulunay B, Eksioglu M, Gurler S. The efficiency of bedside ultrasonography in patients with wrist injury and comparison with other radiological imaging methods: A prospective study. Am J Emerg Med 2017; 35:855-859. [PMID: 28139307 DOI: 10.1016/j.ajem.2017.01.043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/30/2016] [Accepted: 01/23/2017] [Indexed: 11/20/2022] Open
Abstract
STUDY OBJECTIVE Our aim was to determine the efficiency of ultrasound (US) scanning in patients with wrist trauma admitted to the emergency department and to compare US diagnostic usage with other radiological imaging methods. METHODS Patients who presented to the emergency department with wrist injury and who met the inclusion criteria and exclusion criteria were eligible. For all patients, US evaluation of the whole wrist was performed by an emergency physician before other radiological imaging methods (radiographies, computed tomography (CT) and magnetic resonance (MR) imaging). All of the patients included in the study underwent US, radiography, CT, and MR. RESULTS During the study, 122 patients were admitted with a wrist injury. After filtering for the exclusion criteria, 80 patients were included in the study. The sensitivity of US scanning in detecting fractures was 95.31% (95% confidence interval [CI]: 87.1-98.39), the specificity was 93.75% (95% CI: 71.67-98.89), and the positive predictive value was 98.39% (95% CI: 91.72-99.85), and the negative predictive value was 83.33% (95% CI: 72.98-90.41). The sensitivity of US scanning in detecting tendon and ligamentous structural injury was 66.67% (95% CI: 41.71-84.82), the specificity was 100% (95% CI: 94.42-100), the positive predictive value was 100% (95% CI: 94.29-99.89), and the negative predictive was 92.86% (95% CI: 84.25-97.14). CONCLUSION US scanning is an effective method that can be applied in the emergency department to adult patients to diagnose distal forearm and carpal bones fractures. In soft tissue injuries, US and MR examinations produce similar results.
Collapse
Affiliation(s)
- Ahmet Burak Oguz
- Gumushane State Hospital, Department of Emergency, Gumushane, Turkey.
| | - Onur Polat
- Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey
| | - Muge Gunalp Eneyli
- Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey
| | - Behnan Gulunay
- Sivas Numune Hospital, Department of Emergency, Sivas, Turkey
| | - Merve Eksioglu
- Okmeydani Training and Research Hospital, Department of Emergency Medicine, Istanbul, Turkey
| | - Serdar Gurler
- Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey
| |
Collapse
|
8
|
Abstract
Ultrasonography facilitates dynamic, real-time evaluation of bones, joints, tendons, nerves, and vessels, making it an ideal imaging modality for hand and wrist conditions. Ultrasonography can depict masses and fluid collections, help locate radiolucent foreign bodies, characterize traumatic or overuse tendon or ligament pathology, and help evaluate compressive peripheral neuropathy and microvascular blood flow. Additionally, this modality improves the accuracy of therapeutic intra-articular or peritendinous injections and facilitates aspiration of fluid collections, such as ganglia.
Collapse
|
9
|
Interventional Musculoskeletal Ultrasound. CURRENT RADIOLOGY REPORTS 2015. [DOI: 10.1007/s40134-015-0105-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
10
|
Abstract
There have been immense technical innovations and broadened clinical applications of ultrasound in the musculoskeletal system over the past 20 years. Specifically with regard to the hand and wrist, the advent of higher resolution transducers and postprocessing software applications have resulted in overall enhanced visualization of soft tissue structures (tendons/ligaments) as well as surface osseous lesions such as subclinical erosions in rheumatoid arthritis. Quantitative ultrasound, using either power Doppler or contrast-enhanced imaging, has become a central outcomes measure used to evaluate and document patient response to treatment in inflammatory arthropathies such as rheumatoid arthritis. This review will summarize the current state of clinical applications of ultrasound in the evaluation of the hand and wrist, with a summary of technical advances and specific applications in rheumatologic conditions.This review was exempt from institutional review board approval.
Collapse
|
11
|
Abstract
OBJECTIVE The purpose of this article is to review a number of diagnostic pitfalls related to ultrasound evaluation of the hand and wrist. Such pitfalls relate to evaluation of ten-dons (extensor retinaculum, multiple tendon fascicles, tendon subluxation), inflammatory arthritis (incomplete evaluation, misinterpretation of erosions, failure to evaluate for enthesitis), carpal tunnel syndrome (inaccurate measurements, postoperative assessment), ulnar collateral ligament of the thumb (misinterpretation of the adductor aponeurosis and displaced tear), wrist ganglion cysts (incomplete evaluation and misdiagnosis), and muscle variants. CONCLUSION Although ultrasound has been shown to be an effective imaging method for assessment of many pathologic conditions of the wrist, knowledge of potential pitfalls is essential to avoid misdiagnosis and achieve high diagnostic accuracy.
Collapse
|
12
|
Neglected ruptured flexor carpi ulnaris tendon mimics a soft tissue tumor in the wrist. Am J Phys Med Rehabil 2013; 93:355-8. [PMID: 24247758 DOI: 10.1097/phm.0000000000000030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A wrist mass is rarely caused by a ruptured tendon in the forearm. The common pathologies are ganglia, tendon tenosynovitis, and giant cell tumors of tendon sheaths. Less common causes are nerve sheath tumors, vascular lesions, or an accessory muscle belly. The authors investigated a case of neglected ruptured flexor carpi ulnaris tendon that mimics a mass in the wrist. To the authors' knowledge, this is the first case report in relevant literature. During investigation, the high-resolution musculoskeletal ultrasound suggested a soft tissue tumor or a ruptured flexor carpi ulnaris tendon. The magnetic resonance imaging scan indicated an accessory flexor carpi ulnaris muscle belly. The diagnosis of ruptured flexor carpi ulnaris tendon was confirmed by surgical exploration. This case indicates that ultrasound may be better suited than magnetic resonance imaging in evaluating a wrist mass for its accuracy, availability, and portability.
Collapse
|
13
|
Hajder E, de Jonge MC, van der Horst CMAM, Obdeijn MC. The role of ultrasound-guided triamcinolone injection in the treatment of de Quervain's disease: treatment and a diagnostic tool? ACTA ACUST UNITED AC 2013; 32:403-7. [PMID: 24139754 DOI: 10.1016/j.main.2013.09.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 07/23/2013] [Accepted: 09/08/2013] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to describe the technique and usefulness of ultrasound-guided intrasheath injection of triamcinolone in the treatment of de Quervain's disease (dQD). Our study was retrospective in design. Seventy-one wrists of 62 patients who were treated with an ultrasound-guided triamcinolone injection for dQD were included. A literature search was performed to compare our results. In the literature we found supportive evidence that accurate injection of triamcinolone in the first dorsal compartment of the wrist is important for a good outcome. In this retrospective study we found that treatment with ultrasound-guided injections of triamcinolone is both safe and effective. After two injections, 91% of the patients had good long-term results, which is a higher cure rate than found in most other studies. Furthermore, we found that Finkelstein's test can give a false positive result. Therefore, ultrasound should not only be considered to improve the treatment outcome, but can also be useful as a diagnostic tool in the management of de Quervain's disease.
Collapse
Affiliation(s)
- E Hajder
- Academic Medical Center, University of Amsterdam, Department of Plastic, Reconstructive and Hand Surgery, Meibergdreef 9, 1105 Amsterdam, AZ, The Netherlands.
| | - M C de Jonge
- Academic Medical Center, University of Amsterdam, Department of Radiology, Meibergdreef 9, 1105 Amsterdam, AZ, The Netherlands
| | - C M A M van der Horst
- Academic Medical Center, University of Amsterdam, Department of Plastic, Reconstructive and Hand Surgery, Meibergdreef 9, 1105 Amsterdam, AZ, The Netherlands.
| | - M C Obdeijn
- Academic Medical Center, University of Amsterdam, Department of Plastic, Reconstructive and Hand Surgery, Meibergdreef 9, 1105 Amsterdam, AZ, The Netherlands.
| |
Collapse
|
14
|
Wu TS, Roque PJ, Green J, Drachman D, Khor KN, Rosenberg M, Simpson C. Bedside ultrasound evaluation of tendon injuries. Am J Emerg Med 2012; 30:1617-21. [DOI: 10.1016/j.ajem.2011.11.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 10/26/2011] [Accepted: 11/07/2011] [Indexed: 10/14/2022] Open
|
15
|
Fedorczyk JM. Tendinopathies of the elbow, wrist, and hand: histopathology and clinical considerations. J Hand Ther 2012; 25:191-200; quiz 201. [PMID: 22507213 DOI: 10.1016/j.jht.2011.12.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 12/02/2011] [Accepted: 12/05/2011] [Indexed: 02/03/2023]
Abstract
This article reviews the current opinion of the histopathological findings of common elbow, wrist, and hand tendinopathies. Implications for client management including examination, diagnosis, prognosis, intervention, and outcomes are addressed. Concepts for further research regarding common therapeutic interventions are discussed.
Collapse
Affiliation(s)
- Jane M Fedorczyk
- Department of Physical Therapy & Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania 19102, USA.
| |
Collapse
|
16
|
Rousset P, Vuillemin-Bodaghi V, Laredo JD, Parlier-Cuau C. Anatomic variations in the first extensor compartment of the wrist: accuracy of US. Radiology 2010; 257:427-33. [PMID: 20829530 DOI: 10.1148/radiol.10092265] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To evaluate the accuracy of ultrasonography (US) in determining the anatomic variations in the first extensor compartment of the wrist. MATERIALS AND METHODS Approval from the anatomic donations department was obtained. The first extensor compartment of the wrist of 40 nonembalmed cadaveric forearms (15 male and 25 female; age range at death, 65-100 years) were assessed at US by two observers for the presence or absence of a vertical septum, the presence or absence of an osseous ridge with a double groove in the bony floor, and whether there were single or multiple slips of the abductor pollicis longus and the extensor pollicis brevis tendons. These findings were also evaluated at dissection. RESULTS The accuracies of US in depicting a septum and an osseous ridge with a double groove were respectively 95% (95% confidence interval [CI]: 83%, 99%) and 100% (95% CI: 91%, 100%). At dissection, a septum was invariably associated with the presence of an osseous ridge. The accuracies of US in depicting multiple tendon slips of the abductor pollicis longus and the extensor pollicis brevis were respectively 80% (95% CI: 64%, 91%) and 97% (95% CI: 86%, 100%). CONCLUSION US was highly accurate in depicting anatomic variations in the first extensor compartment. US detection of an osseous ridge was an indirect sign of the presence of a septum dividing the first extensor compartment into two subcompartments.
Collapse
Affiliation(s)
- Pascal Rousset
- Department of Radiology, Université Paris Descartes, Assistance Publique des Hôpitaux de Paris, Hôpital Hôtel Dieu, 1 Place du Parvis Notre Dame, 75004 Paris, France.
| | | | | | | |
Collapse
|
17
|
Harish S, O'Neill J, Finlay K, Jurriaans E, Friedman L. Ultrasound of Wrist Pain. Curr Probl Diagn Radiol 2009; 38:111-25. [DOI: 10.1067/j.cpradiol.2008.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
18
|
Communicating foramen between the tendon sheaths of the extensor carpi radialis brevis and extensor pollicis longus muscles: imaging of cadavers and patients. AJR Am J Roentgenol 2007; 189:1190-7. [PMID: 17954660 DOI: 10.2214/ajr.07.2281] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the anatomic features and imaging appearance of the intersection of the extensor pollicis longus (EPL) tendon with the extensor carpi radialis brevis (ECRB) and longus (ECRL) tendons in cadavers and patients. MATERIALS AND METHODS MR and CT tenography were performed on 10 cadaveric wrists, and tenosynovial endoscopy and dissection of the EPL tendon sheath were performed on five additional cadaveric wrists. A computer-assisted search of dictated MRI reports identified 12 wrists of patients with simultaneous EPL tenosynovitis and ECRB and ECRL tenosynovitis. The relation between EPL tenosynovitis and ECRB and ECRL tenosynovitis was studied with chi-square testing. Interobserver agreement was calculated with kappa statistics. RESULTS MR and CT tenography revealed a communicating foramen between the sheaths of the ECRB and EPL tendons in all 10 cadavers studied. Endoscopic evaluation and dissection of five additional cadaveric wrists further confirmed the presence of foramina. In the patients, the presence of EPL tenosynovitis and that of ECRB and ECRL tenosynovitis had strong correlation (p < 0.001). The incidence of simultaneous EPL tenosynovitis and ECRB and ECRL tenosynovitis in our referral population of wrist MRI examinations was 0.8% (12/1,540). CONCLUSION A normal foramen exists between the sheaths of the EPL and ECRB tendons where they intersect in the wrist. Such foramina allow synovial fluid to communicate between the tendon sheaths and probably account for the high prevalence of tenosynovitis in more than one tendon on clinical MRI studies.
Collapse
|
19
|
|
20
|
Abstract
A review of the current state of the relevant diagnostic imaging technologies and methods and their clinical application in imaging common conditions of the hand, wrist, and forearm is presented. Evolving and future imaging technologies are also considered.
Collapse
|
21
|
Müller MA, Wildermuth S, Bohndorf K. Traumatic Injuries: Imaging of Peripheral Muskuloskeletal Injuries. Emerg Radiol 2007. [DOI: 10.1007/978-3-540-68908-9_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
22
|
|
23
|
Kijowski R, De Smet AA. The role of ultrasound in the evaluation of sports medicine injuries of the upper extremity. Clin Sports Med 2006; 25:569-90, viii. [PMID: 16798143 DOI: 10.1016/j.csm.2006.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The two major imaging modalities used for assessment of soft tissue injuries are ultrasound and MRI. Although ultrasound of the extremities is used only to a limited extent in the United States, it is widely used in many other countries for evaluation of extremity injuries. This article first considers the advantages and disadvantages of MRI and ultrasound. Understanding these differences will help the reader understand the role of ultrasound as compared with MRI in evaluating upper extremity injuries. The uses of ultrasound for evaluating sports medicine injuries in specific regions of the upper extremity are then reviewed. Where the data are available, the reported accuracy of ultrasound is compared with MRI for each type of injury.
Collapse
Affiliation(s)
- Richard Kijowski
- Division of Musculoskeletal Radiology, Department of Radiology, University of Wisconsin Clinical Science Center, 600 Highland Avenue, E3/311 CSC, Madison, WI 53792-3252, USA.
| | | |
Collapse
|
24
|
Ebrahim FS, De Maeseneer M, Jager T, Marcelis S, Jamadar DA, Jacobson JA. US Diagnosis of UCL Tears of the Thumb and Stener Lesions: Technique, Pattern-based Approach, and Differential Diagnosis. Radiographics 2006; 26:1007-20. [PMID: 16844929 DOI: 10.1148/rg.264055117] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The thumb is a central component supporting the intricate movements of the hand. Patients with acute thumb pain, particularly after trauma, require prompt evaluation of structural integrity, thus avoiding long-term morbidity such as instability, chronic pain, and osteoarthritis. Injury to the ulnar collateral ligament (UCL) of the thumb requires imaging for diagnosis of surgically important entities such as the Stener lesion. Historically, routine radiography including stress views does not allow such diagnosis and is potentially detrimental to patient care. Both magnetic resonance imaging and ultrasonography (US) are currently used for direct evaluation of the UCL of the thumb and are safe and accurate. US is more dynamic and less time-consuming and may be easier to perform. Furthermore, other disorders such as tenosynovitis, tendon tears, and articular pathologic conditions can involve the thumb and thenar region and may also be diagnosed with US. In this context, US is an underused tool because it is potentially an adjunct to the clinical examination in the appropriate setting. A sound knowledge of the regional anatomy and basic training in the principles of US should equip the imager with the skills necessary to evaluate the UCL of the thumb and its surrounding structures.
Collapse
Affiliation(s)
- Farhad S Ebrahim
- Department of Radiology, University of Michigan Health System, Taubman/B-1/Room 132, Box 0302, 1500 E Medical Center Dr, Ann Arbor, MI 48109-0302, USA.
| | | | | | | | | | | |
Collapse
|