關節攝影在腕關節疾病診斷之應用

Arthrographic Studies of Wrist Joint Diseases

張政彥(Cheng-Yen Chang) ； 邱宏仁(Hong-Jen Chiou) ； 陳坤煌(Clement KH Chen) ； 詹益豐(Yick-Fung Jim) ； 鄧木火(Michael MH Teng) ； 張遵(Tsuen Chang)

《中華放射線醫學雜誌》 16卷1期 (1991/03) Pp. 21-27

摘要

224位非骨折性腕關節不適病患中有49例因慢性腕關節疼痛接受腕關節攝影(wrist arthrography)檢查；方法是經由橈舟關節(radio-scaphoid joint)的中點注射約2 c.c.的對比劑，發現到有21例其對比劑進入遠端橈尺關節(distal radio-ulnar joint)腔，21例有中腕間隔(mid-carpal compartment)顯影，其中10例是二者合併發生的。於所有接受腕關節攝影病患中有25例豆三角間隔(pisotriquetrum compartment)顯影，只有17例是正常的關節攝影。在21例三角骨韌帶群（triangular fibrocartilage complex以下簡稱TFCC）斷裂而引起遠端橈尺關節異常顯影中，有17例TFCC斷裂的位置發生於距橈骨乙狀凹(sigmoid fossa)3 mm以內，約佔81%。在46例尺骨變數(ulnar variance)為正常或正值之中有20例TFCC斷裂，3例尺骨變數為負值的病患中有1例是TFCC斷裂，就統計學分析尺骨變數與TFCC之斷裂應是沒有明顯的關係。本文目的乃是介紹腕關節攝影的適應症，我們49例腕關節攝影研究結果分析報告並將經驗提出討論。

關鍵字

腕關節 ； 關節攝影 ； 三角纖維軟骨韌帶群 ； 尺骨變數

並列摘要

Forty-nine out of 224 patients of non-fractured wrist discomfort with chronic wrist pain were selected to have arthrograms. The arthrography was performed with 2 c. c of non-ionic contrast medium via the radio-scaphoid joint injection. Twenty-one cases showed distal radio-ulnar joint opacification and 21 cases showed mid-carpal compartment opacification. Among them, 10 had both compartments opacification also. Twenty-five cases showed piso-triquetral compartment opacification. Seventeen cases had normal arthrogram. Among 21 cases of triangular fibrocartilage complex (TFCC) tear, 17 (81%) showed the sites of tear to be within 3 mm from the sigmoid fossa of radius. Among 46 cases of normal or positive ulnar variance, 20 cases showed TFCC tear; only 1 case out of 3 of negative ulnar variance had TFCC tear. Statistical analysis showed no significant correlation between TFCC tear and ulnar variance. This study aims to introduce the indication of wrist arthrography, and present our results and experiences for discussion.

並列關鍵字

wrist ； arthrography ； triangular fibrocartilage complex ； ulnar variance