R M van Vugt1, A van Dalen, J W Bijlsma. 1. Department of Rheumatology and Clinical Immunology, University Hospital Utrecht, The Netherlands.
Abstract
OBJECTIVE: To assess the current role of ultrasound in the diagnosis and treatment of pathological changes in the wrist and hand. METHODS: 39 patients (14 male and 25 female, mean age 35 yrs.) with ill-defined pain and/or swelling of the wrist or hand were examined using a high-definition ultrasound (US) instrument. RESULTS: 18 patients had tenosynovitis, which in one patient was due to a previously unsuspected foreign body. 10 patients had arthritis involving the wrist and 5 the fingers; 2 patients had a ganglion; one had a neuroma of the median nerve and one patient with a previous tenorrhaphy suffered from the recurrent rupture of this tendon. Two patients had carpal tunnel syndrome, one due to tenosynovitis and one due to the formation of a post-operative fibrotic sheath around the median nerve. 7 patients with synovitis of the wrist underwent US-guided synovial biopsy. 12 patients with tenosynovitis and 6 with arthritis received injections of corticosteroids plus anaesthetic under US-guidance. The spreading of the steroid crystals around the tendon and throughout the joint could be easily monitored. No complications were encountered. CONCLUSION: High-definition ultrasound is a valuable technique for the imaging of pathologic changes of the wrist and hand and for injection therapy.
OBJECTIVE: To assess the current role of ultrasound in the diagnosis and treatment of pathological changes in the wrist and hand. METHODS: 39 patients (14 male and 25 female, mean age 35 yrs.) with ill-defined pain and/or swelling of the wrist or hand were examined using a high-definition ultrasound (US) instrument. RESULTS: 18 patients had tenosynovitis, which in one patient was due to a previously unsuspected foreign body. 10 patients had arthritis involving the wrist and 5 the fingers; 2 patients had a ganglion; one had a neuroma of the median nerve and one patient with a previous tenorrhaphy suffered from the recurrent rupture of this tendon. Two patients had carpal tunnel syndrome, one due to tenosynovitis and one due to the formation of a post-operative fibrotic sheath around the median nerve. 7 patients with synovitis of the wrist underwent US-guided synovial biopsy. 12 patients with tenosynovitis and 6 with arthritis received injections of corticosteroids plus anaesthetic under US-guidance. The spreading of the steroid crystals around the tendon and throughout the joint could be easily monitored. No complications were encountered. CONCLUSION: High-definition ultrasound is a valuable technique for the imaging of pathologic changes of the wrist and hand and for injection therapy.
Authors: Anika Filius; Marjan Scheltens; Hans G Bosch; Pieter A van Doorn; Henk J Stam; Steven E R Hovius; Peter C Amadio; Ruud W Selles Journal: J Orthop Res Date: 2015-05-07 Impact factor: 3.494