Arthrography in the Evaluation of Posttraumatic Wrist Pain

利用腕關節造影攝影評估外傷引起的腕關節疼痛

鄭貴麟(Kwee-Lin Tay) ； 曾觀達(Koon-Tat Tsang) ； 鄧世雄(Sai-Hung Tang) ； 陳嘉美(Margaret Chia-Mei Chen) ； 陳鑑江(Kam-Kong Chan) ； 金學志(Hsueh-Chih King) ； 郭國平(Kou-Ping Kuo)

《中華放射線醫學雜誌》 17卷4期 (1992/12) Pp. 359-367

摘要

This retrospectively study included 50 patients with post-traumatic wrist pain that received wrist arthrougraphy in our hospital from July 1987 to June 1991. Normally, radiocarpal joint (RCJ), midcarpal joint (MCJ) and distal radioulnar joint (DRUJ) are anatomically separate and should not communicate. Opacification of midcarpal or distal radioulnar joint in conventional radiocarpal injection indicates abnormality. There were totally 32 abnormalities in 50 arthrograms, including 19 cases of complete perforation of triangular fibrocartilage complex (TFCC) and 3 cases of partial tear of TFCC. 77% of them showed communication of DRUJ with RCJ via radial side, associated with younger age in our population (33.8 years). Trauma instead of degeneration was considered to contribute to this TFCC perforation. There were 10 cases of ulnar plus variance in our study. All of them showed TFCC perforation, indicating high correlation of ulnar plus variance with TFCC perforation (p＜0.01). Opacification of MCJ was noted in 7 cases, including 5 with lunotriquetral (LT) ligament and 4 with scapholunate (SL) ligament disruption, which could be demonstrated by sequential spot films to detect the flow of contast medium leakage into MCJ from RCJ. All 12 (54.5%) cases with TFCC or interosseous ligament disruption were confirmed by surgical procedure. In conclusion, wrist arthrography remains an important and accurate modality for evaluation of post traumatic wrist pain.

關鍵字

腕關節腕外傷 ； 腕關節造影

並列摘要

This retrospectively study included 50 patients with post-traumatic wrist pain that received wrist arthrougraphy in our hospital from July 1987 to June 1991. Normally, radiocarpal joint (RCJ), midcarpal joint (MCJ) and distal radioulnar joint (DRUJ) are anatomically separate and should not communicate. Opacification of midcarpal or distal radioulnar joint in conventional radiocarpal injection indicates abnormality. There were totally 32 abnormalities in 50 arthrograms, including 19 cases of complete perforation of triangular fibrocartilage complex (TFCC) and 3 cases of partial tear of TFCC. 77% of them showed communication of DRUJ with RCJ via radial side, associated with younger age in our population (33.8 years). Trauma instead of degeneration was considered to contribute to this TFCC perforation. There were 10 cases of ulnar plus variance in our study. All of them showed TFCC perforation, indicating high correlation of ulnar plus variance with TFCC perforation (p＜0.01). Opacification of MCJ was noted in 7 cases, including 5 with lunotriquetral (LT) ligament and 4 with scapholunate (SL) ligament disruption, which could be demonstrated by sequential spot films to detect the flow of contast medium leakage into MCJ from RCJ. All 12 (54.5%) cases with TFCC or interosseous ligament disruption were confirmed by surgical procedure. In conclusion, wrist arthrography remains an important and accurate modality for evaluation of post traumatic wrist pain.

並列關鍵字

Wrist, arthrography ； wrist, injruy ； joints, wrist