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Erschienen in: Skeletal Radiology 6/2014

01.06.2014 | Scientific Article

Association between distal ulnar morphology and extensor carpi ulnaris tendon pathology

verfasst von: Connie Y. Chang, Ambrose J. Huang, Miriam A. Bredella, Susan V. Kattapuram, Martin Torriani

Erschienen in: Skeletal Radiology | Ausgabe 6/2014

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Abstract

Objective

The purpose of this study was to evaluate the association between distal ulnar morphology and extensor carpi ulnaris (ECU) tendon pathology.

Materials and methods

We retrospectively reviewed 71 adult wrist MRI studies with ECU tendon pathology (tenosynovitis, tendinopathy, or tear), and/or ECU subluxation. Subjects did not have a history of trauma, surgery, infection, or inflammatory arthritis. MRI studies from 46 subjects without ECU tendon pathology or subluxation were used as controls. The following morphological parameters of the distal ulna were measured independently by two readers: ulnar variance relative to radius, ulnar styloid process length, ECU groove depth and length. Subjects and controls were compared using Student’s t test. Inter-observer agreement (ICC) was calculated.

Results

There was a significant correlation between negative ulnar variance and ECU tendon pathology (reader 1 [R1], P = 0.01; reader 2 [R2], P < 0.0001; R1 and R2 averaged data, P < 0.0001) and ECU tendon subluxation (P = 0.001; P = 0.0001; P < 0.0001). In subjects with ECU tendon subluxation there was also a trend toward a shorter length (P = 0.3; P <0.0001; P = 0.001) and a shallower ECU groove (P = 0.01; P = 0.03; P = 0.01; R1 and R2 averaged data with Bonferroni correction, P = 0.08). ECU groove depth (P = 0.6; P = 0.8; P = 0.9) and groove length (P = 0.1; P = 0.4; P = 0.7) showed no significant correlation with ECU tendon pathology, and length of the ulnar styloid process showed no significant correlation with ECU tendon pathology (P = 0.2; P = 0.3; P = 0.2) or subluxation (P = 0.4; P = 0.5; P = 0.5). Inter-observer agreement (ICC) was >0.64 for all parameters.

Conclusion

Distal ulnar morphology may be associated with ECU tendon abnormalities.
Literatur
1.
Zurück zum Zitat Crema MD, Marra MD, Guermazi A, Roemer FW, Bohndorf K, Jomaah N. MDCT arthrography features of ulnocarpal impaction syndrome. AJR Am J Roentgenol. 2009;193:1376–81.PubMedCrossRef Crema MD, Marra MD, Guermazi A, Roemer FW, Bohndorf K, Jomaah N. MDCT arthrography features of ulnocarpal impaction syndrome. AJR Am J Roentgenol. 2009;193:1376–81.PubMedCrossRef
2.
Zurück zum Zitat Sachar K. Ulnar-sided wrist pain: evaluation and treatment of triangular fibrocartilage complex tears, ulnocarpal impaction syndrome, and lunotriquetral ligament tears. J Hand Surg Am. 2008;33:1669–79.PubMedCrossRef Sachar K. Ulnar-sided wrist pain: evaluation and treatment of triangular fibrocartilage complex tears, ulnocarpal impaction syndrome, and lunotriquetral ligament tears. J Hand Surg Am. 2008;33:1669–79.PubMedCrossRef
3.
4.
Zurück zum Zitat Czitrom AA, Dobyns JH, Linscheid RL. Ulnar variance in carpal instability. J Hand Surg Am. 1987;12:205–8.PubMedCrossRef Czitrom AA, Dobyns JH, Linscheid RL. Ulnar variance in carpal instability. J Hand Surg Am. 1987;12:205–8.PubMedCrossRef
5.
Zurück zum Zitat Jeantroux J, Becce F, Guerini H, Montalvan B, Le Viet D, Drapé J-L. Athletic injuries of the extensor carpi ulnaris subsheath: MRI findings and utility of gadolinium-enhanced fat-saturated T1-weighted sequences with wrist pronation and supination. Eur Radiol. 2011;21:160–6.PubMedCrossRef Jeantroux J, Becce F, Guerini H, Montalvan B, Le Viet D, Drapé J-L. Athletic injuries of the extensor carpi ulnaris subsheath: MRI findings and utility of gadolinium-enhanced fat-saturated T1-weighted sequences with wrist pronation and supination. Eur Radiol. 2011;21:160–6.PubMedCrossRef
6.
Zurück zum Zitat Wolfe SW. Green’s operative hand surgery. 6th ed. Philadelphia: Elsevier Churchill Livingstone; 2011. Wolfe SW. Green’s operative hand surgery. 6th ed. Philadelphia: Elsevier Churchill Livingstone; 2011.
7.
Zurück zum Zitat Graham TJ. Pathologies of the extensor carpi ulnaris (ECU) tendon and its investments in the athlete. Hand Clin. 2012;28:345–56.PubMedCrossRef Graham TJ. Pathologies of the extensor carpi ulnaris (ECU) tendon and its investments in the athlete. Hand Clin. 2012;28:345–56.PubMedCrossRef
8.
Zurück zum Zitat Montalvan B, Parier J, Brasseur JL, Le Viet D, Drape JL. Extensor carpi ulnaris injuries in tennis players: a study of 28 cases. Br J Sports Med. 2006;40:424–9. discussion 429.PubMedCentralPubMedCrossRef Montalvan B, Parier J, Brasseur JL, Le Viet D, Drape JL. Extensor carpi ulnaris injuries in tennis players: a study of 28 cases. Br J Sports Med. 2006;40:424–9. discussion 429.PubMedCentralPubMedCrossRef
9.
Zurück zum Zitat Iida A, Omokawa S, Moritomo H, Aoki M, Wada T, Kataoka T, et al. Biomechanical study of the extensor carpi ulnaris as a dynamic wrist stabilizer. J Hand Surg Am. 2012;37:2456–61.PubMedCrossRef Iida A, Omokawa S, Moritomo H, Aoki M, Wada T, Kataoka T, et al. Biomechanical study of the extensor carpi ulnaris as a dynamic wrist stabilizer. J Hand Surg Am. 2012;37:2456–61.PubMedCrossRef
10.
Zurück zum Zitat Cerezal L, del Piñal F, Abascal F, García-Valtuille R, Pereda T, Canga A. Imaging findings in ulnar-sided wrist impaction syndromes. Radiographics. 2002;22:105–21.PubMedCrossRef Cerezal L, del Piñal F, Abascal F, García-Valtuille R, Pereda T, Canga A. Imaging findings in ulnar-sided wrist impaction syndromes. Radiographics. 2002;22:105–21.PubMedCrossRef
11.
Zurück zum Zitat De Smet L, Claessens A, Fabry G. Gymnast wrist. Acta Orthop Belg. 1993;59:377–80.PubMed De Smet L, Claessens A, Fabry G. Gymnast wrist. Acta Orthop Belg. 1993;59:377–80.PubMed
12.
Zurück zum Zitat Laino DK, Petchprapa CN, Lee SK. Ulnar variance: correlation of plain radiographs, computed tomography, and magnetic resonance imaging with anatomic dissection. J Hand Surg Am. 2012;37:90–7.PubMedCrossRef Laino DK, Petchprapa CN, Lee SK. Ulnar variance: correlation of plain radiographs, computed tomography, and magnetic resonance imaging with anatomic dissection. J Hand Surg Am. 2012;37:90–7.PubMedCrossRef
13.
Zurück zum Zitat Zlatkin MB, Rosner J. MR imaging of ligaments and triangular fibrocartilage complex of the wrist. Magn Reson Imaging Clin N Am. 2004;12:301–31. vi–vii.PubMedCrossRef Zlatkin MB, Rosner J. MR imaging of ligaments and triangular fibrocartilage complex of the wrist. Magn Reson Imaging Clin N Am. 2004;12:301–31. vi–vii.PubMedCrossRef
14.
Zurück zum Zitat Pfirrmann CW, Theumann NH, Chung CB, Botte MJ, Trudell DJ, Resnick D. What happens to the triangular fibrocartilage complex during pronation and supination of the forearm? Analysis of its morphology and diagnostic assessment with MR arthrography. Skeletal Radiol. 2001;30:677–85.PubMedCrossRef Pfirrmann CW, Theumann NH, Chung CB, Botte MJ, Trudell DJ, Resnick D. What happens to the triangular fibrocartilage complex during pronation and supination of the forearm? Analysis of its morphology and diagnostic assessment with MR arthrography. Skeletal Radiol. 2001;30:677–85.PubMedCrossRef
15.
Zurück zum Zitat Lee KS, Ablove RH, Singh S, De Smet AA, Haaland B, Fine JP. Ultrasound imaging of normal displacement of the extensor carpi ulnaris tendon within the ulnar groove in 12 forearm-wrist positions. AJR Am J Roentgenol. 2009;193:651–5.PubMedCrossRef Lee KS, Ablove RH, Singh S, De Smet AA, Haaland B, Fine JP. Ultrasound imaging of normal displacement of the extensor carpi ulnaris tendon within the ulnar groove in 12 forearm-wrist positions. AJR Am J Roentgenol. 2009;193:651–5.PubMedCrossRef
16.
Zurück zum Zitat Allende C, Le Viet D. Extensor carpi ulnaris problems at the wrist—classification, surgical treatment and results. J Hand Surg Br. 2005;30:265–72.PubMedCrossRef Allende C, Le Viet D. Extensor carpi ulnaris problems at the wrist—classification, surgical treatment and results. J Hand Surg Br. 2005;30:265–72.PubMedCrossRef
17.
Zurück zum Zitat Spinner M, Kaplan EB. Extensor carpi ulnaris. Its relationship to the stability of the distal radio-ulnar joint. Clin Orthop Relat Res. 1970;68:124–9.PubMed Spinner M, Kaplan EB. Extensor carpi ulnaris. Its relationship to the stability of the distal radio-ulnar joint. Clin Orthop Relat Res. 1970;68:124–9.PubMed
18.
Zurück zum Zitat Hunt TR, Wiesel SW. Operative techniques in hand, wrist, and forearm surgery. Philadelphia: Lippincott Williams and Wilkins; 2010. Hunt TR, Wiesel SW. Operative techniques in hand, wrist, and forearm surgery. Philadelphia: Lippincott Williams and Wilkins; 2010.
19.
Zurück zum Zitat Cooney WP. The wrist: diagnosis and operative treatment. Riverwoods, IL: Lippincott Williams and Wilkins; 2011. Cooney WP. The wrist: diagnosis and operative treatment. Riverwoods, IL: Lippincott Williams and Wilkins; 2011.
20.
Zurück zum Zitat MacLennan AJ, Nemechek NM, Waitayawinyu T, Trumble TE. Diagnosis and anatomic reconstruction of extensor carpi ulnaris subluxation. J Hand Surg Am. 2008;33:59–64.PubMedCrossRef MacLennan AJ, Nemechek NM, Waitayawinyu T, Trumble TE. Diagnosis and anatomic reconstruction of extensor carpi ulnaris subluxation. J Hand Surg Am. 2008;33:59–64.PubMedCrossRef
21.
Zurück zum Zitat Bateni CP, Bartolotta RJ, Richardson ML, Mulcahy H, Allan CH. Imaging key wrist ligaments: what the surgeon needs the radiologist to know. AJR Am J Roentgenol. 2013;200:1089–95.PubMedCrossRef Bateni CP, Bartolotta RJ, Richardson ML, Mulcahy H, Allan CH. Imaging key wrist ligaments: what the surgeon needs the radiologist to know. AJR Am J Roentgenol. 2013;200:1089–95.PubMedCrossRef
22.
Zurück zum Zitat Yeh GL, Beredjiklian PK, Katz MA, Steinberg DR, Bozentka DJ. Effects of forearm rotation on the clinical evaluation of ulnar variance. J Hand Surg Am. 2001;26:1042–6.PubMedCrossRef Yeh GL, Beredjiklian PK, Katz MA, Steinberg DR, Bozentka DJ. Effects of forearm rotation on the clinical evaluation of ulnar variance. J Hand Surg Am. 2001;26:1042–6.PubMedCrossRef
23.
Zurück zum Zitat Tomaino MM. The importance of the pronated grip x-ray view in evaluating ulnar variance. J Hand Surg Am. 2000;25:352–7.PubMedCrossRef Tomaino MM. The importance of the pronated grip x-ray view in evaluating ulnar variance. J Hand Surg Am. 2000;25:352–7.PubMedCrossRef
24.
Zurück zum Zitat Pratt RK, Hoy GA, Bass FC. Extensor carpi ulnaris subluxation or dislocation? Ultrasound measurement of tendon excursion and normal values. Hand Surg. 2004;9:137–43.PubMedCrossRef Pratt RK, Hoy GA, Bass FC. Extensor carpi ulnaris subluxation or dislocation? Ultrasound measurement of tendon excursion and normal values. Hand Surg. 2004;9:137–43.PubMedCrossRef
Metadaten
Titel
Association between distal ulnar morphology and extensor carpi ulnaris tendon pathology
verfasst von
Connie Y. Chang
Ambrose J. Huang
Miriam A. Bredella
Susan V. Kattapuram
Martin Torriani
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Skeletal Radiology / Ausgabe 6/2014
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-014-1845-2

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