Abstract
Most of the diagnosis of ulnar-sided wrist pain relies on clinical findings supported by conventional radiology. When a particular disease is suspected, it may be useful to carry out specific radiographic projections. Ultrasound is the most useful tool for the diagnosis of tendon pathology and compressive neuropathies. Ultrasound facilitates guidance of infiltrations and interventional procedures. MDCT’s role is the diagnosis of occult fractures and three-dimensional evaluation of fractures, especially in articular fractures. MR imaging is a useful tool for the diagnosis of most intra-articular and extra-articular pathologies of the wrist. However, MR imagingstill have two major limitations, diagnosis of lesions of TFCC Palmer class 1B and carpal instability. Arthrographic sectional techniques (CT arthrography and MR arthrography) may overcome these limitations of conventional MR imaging, allowing a precise diagnosis of TFCC lesions, LT ligament injuries, and midcarpal instability.
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References
Allende C, Le Viet D (2005) Extensor carpi ulnaris problems at the wrist: classification, surgical treatment and results. J Hand Surg Br 30:265–272
Amrami KK, Moran SL, Berger RA et al (2010) Imaging the distal radioulnar joint. Hand Clin 26:467–475
Anderson ML, Skinner JA, Felmlee JP et al (2008) Diagnostic comparison of 1.5 Tesla and 3.0 Tesla preoperative MRI of the wrist in patients with ulnar-sided wrist pain. J Hand Surg Am 33(7):1153–1159
Atzei A (2010) Arthroscopic management of DRUJ instability following TFCC ulnar tears. In: Del Piñal F, Mathoulin C, Luchetti R (eds) Arthroscopic management of distal radius fractures. Springer, Berlin
Atzei A, Luchetti R (2011) Foveal TFCC tear classification and treatment. Hand Clin 27:263–272
Bianchi S, Montet X, Martinoli C et al (2004) High-resolution sonography of compressive neuropathies of the wrist. J Clin Ultrasound 32(9):451–461
Bille B, Harley B, Cohen H (2007) A comparison of CT arthrography of the wrist to findings during wrist arthroscopy. J Hand Surg Am 32(6):834–841
Blum AG, Zabel JP, Kohlmann R et al (2006) Pathologic conditions of the hypothenar eminence: evaluation with multidetector CT and MR imaging. Radiographics 26:1021–1044
Bordalo-Rodrigues M, Amin P, Rosenberg ZS (2004) MR imaging of common entrapment neuropathies at the wrist. Magn Reson Imaging Clin N Am 12(2):265–279
Borelli P, Luchetti R (2010) Treatment of the associated ulnar-sided problems. In: Del Piñal F, Mathoulin C, Luchetti R (eds) Arthroscopic management of distal radius fractures. Springer, Berlin
Buck FM, Gheno R, Nico MAC et al (2009) Ulnomeniscal homologue of the wrist: correlation of anatomic and MR imaging findings. Radiology 253(3):771–779
Budoff JE, Kraushaar BS, Ayala G (2005) Flexor carpi ulnaris tendinopathy. J Hand Surg Am 30(1):125–129
Burns J, Tanaka T, Ueno T et al (2011) Pitfalls that may mimic injuries of the triangular fibrocartilage and proximal intrinsic wrist ligaments at MR imaging. Radiographics 31:63–78
Buterbaugh GA, Brown TR, Horn PC (1998) Ulnar-sided wrist pain in athletes. Clin Sports Med 17(3):567–583
Cerezal L, Del Piñal F, Abascal F et al (2002) Imaging findings in ulnar-sided wrist impaction syndromes. Radiographics 22:105–121
Cerezal L, Del Piñal F, Abascal F (2004) MR imaging findings in ulnar-sided wrist impaction syndromes. Magn Reson Imaging Clin N Am 12:281–299
Cerezal L, Abascal F, García-Valtuille R, Del Piñal F (2005) Wrist MR arthrography: how, why, when. Radiol Clin North Am 43:709–731
Coggins CA (2006) Imaging of ulnar-sided wrist pain. Clin Sports Med 25:505–526
De Filippo M, Pogliacomi F, Bertellini A et al (2010) MDCT arthrography of the wrist: diagnostic accuracy and indications. Eur J Radiol 74(1):221–225
del Piñal F (2009) The 1B constellation. Presented at the FESSH Congress in Poznan, Poland. Book of abstracts
Fontés D (2010) Lunotriquetral and extrinsic ligaments lesions associated with distal radius fractures. In: Del Piñal F, Mathoulin C, Luchetti R (eds) Arthroscopic management of distal radius fractures. Springer, Berlin
Friedman SL, Palmer AK (1991) The ulnar impaction syndrome. Hand Clin 7(2):295–310
Garcia-Elias M, Geissler WB (2005) Carpal instability. In: Green DP, Hotchkiss RN, Pederson WC, Wolfe SW (eds) Green’s operative hand surgery. Elsevier Churchill Livingstone, Philadelphia
Goldfarb CA, Yin Y, Gilula LA, et al (2001) Wrist fractures: what the clinician wants to know. Radiology 219(1):1–18
Haims AH, Schweitzer ME, Morrison WB et al (2002) Limitations of MR imaging in the diagnosis of peripheral tears of the triangular fibrocartilage of the wrist. AJR Am J Roentgenol 178(2):419–422
Kaewlai R, Avery LL, Asrani AV et al (2008) Multidetector CT of carpal injuries: anatomy, fractures, and fracture-dislocations. Radiographics 28:1771–1784
Malik AM, Schweitzer ME, Culp RW et al (1999) MR imaging of the type II lunate bone: frequency, extent, and associated findings. AJR Am J Roentgenol 173:335–338
MacLennan AJ, Nemechek NM, Waitayawinyu T, Trumble TE (2008) Diagnosis and anatomic reconstruction of extensor carpi ulnaris subluxation. J Hand Surg Am 33(1):59–64
Moritomo H, Masatomi T, Murase T et al (2010) Open repair of foveal avulsion of the triangular fibrocartilage complex and comparison by types of injury mechanism. J Hand Surg 35(12):1955–1963
Moser T, Dosch JC, Moussaoui A et al (2008) Multidetector CT arthrography of the wrist joint: how to do it. Radiographics 28(3):787–800
Nakamura T (2010) Radial side tear of the triangular fibrocartilage complex. In: Del Piñal F, Mathoulin C, Luchetti R (eds) Arthroscopic management of distal radius fractures. Springer, Berlin
Nishikawa S, Toh S, Miura H, Arai K (2002) The carpal detachment injury of the triangular fibrocartilage complex. J Hand Surg Br 27(1):86–89
Omlor G, Jung M, Grieser T, Ludwig K (2008) Depiction of the triangular fibro-cartilage in patients with ulnar-sided wrist pain: comparison of direct multi-slice CT arthrography and direct MR arthrography. Eur Radiol 19(1):147–151
Palmer AK (1989) Triangular fibrocartilage complex lesions: a classification. J Hand Surg Am 14:594–606
Papp S (2007) Carpal bone fractures. Orthop Clin North Am 38(2):251–260
Protopsaltis TS, Ruch DS (2010) Triangular fibrocartilage complex tears associated with symptomatic ulnar styloid nonunions. J Hand Surg 35(8):1251–1255
Rüegger C, Schmid M, Pfirrmann C et al (2007) Peripheral tear of the triangular fibrocartilage: depiction with MR arthrography of the distal radioulnar joint. AJR Am J Roentgenol 188:187–192
Schmid MR, Schertler T, Pfirrmann CW et al (2005) Interosseous ligament tears of the wrist: comparison of multi-detector row CT arthrography and MR imaging. Radiology 237(3):1008–1013
Slutsky D (2011) Arthroscopic evaluation of the foveal attachment of the triangular fibrocartilage. Hand Clin 27:255–261
Tagliafico A, Rubino M, Autuori A et al (2007) Wrist and hand ultrasound. Semin Musculoskelet Radiol 11(2):95–104
Tanaka T, Ogino S, Yoshioka H (2008) Ligamentous injuries of the wrist. Semin Musculoskelet Radiol 12:359–378
Theumann N, Etechami G, Duvoisin B et al (2006) Association between extrinsic and intrinsic carpal ligament injuries at MR arthrography and carpal instability at radiography: initial observations. Radiology 238:950–957
Thurston AJ, Stanley JK (2000) Hamato-lunate impingement: an uncommon cause of ulnar-sided wrist pain. Arthroscopy 16(5):540–544
Timins ME (1999) Osseous anatomic variants of the wrist: findings on MR imaging. AJR Am J Roentgenol 173:339–344
Toms A, Chojnowski A, Cahir J (2011) Midcarpal instability: a radiological perspective. Skeletal Radiol 40:533–541
Topper SM, Wood MB, Ruby LK (1997) Ulnar styloid impaction syndrome. J Hand Surg Am 22:699–704
Trumble T (2011) Radial side (1D) tears. Hand Clin 27:243–254
Watanabe A, Souza F, Vezeridis PS et al (2010) Ulnar-sided wrist pain. II. Clinical imaging and treatment. Skeletal Radiol 39:837–857
Acknowledgment
I would like to thank my friend, Paco Piñal, whose encouragement, guidance, and support for many years have enabled me to develop an understanding of the subject.
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Cerezal, L., Abascal, F. (2012). Ulnar Imaging for Arthroscopic Surgeons. In: del Piñal, F. (eds) Arthroscopic Management of Ulnar Pain. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-30544-3_5
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DOI: https://doi.org/10.1007/978-3-642-30544-3_5
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