利用磁振造影加壓姿勢診斷拇指尺側側副韌帶斷裂－病例報告

Using MR Stress Position to Diagnose Ulnar Collateral Ligament Tear - Case Report

王琪惠(Chi-Hui Wang,) ； 陳厚勳(Hou-Hsun Chen) ； 賴佩絹(Pei-Jiuan Lai) ； 陳坤煌(Kuen-Huang Chen)

《中華放射線技術學雜誌》 40卷1期 (2016/03) Pp. 41-45

摘要

拇指掌指關節是單一的鉸鏈式關節，平均的屈伸活動為10°-60°，掌指關節和指間關節兩側都有副韌帶加強穩定度，幫忙限制關節的活動度。拇指的掌指關節和其四指的近側指間關節囊比較鬆弛，因此為手部最常見的韌帶損傷。拇指掌指關節尺側側副韌帶損傷會造成疼痛、腫脹，並且有運動受限、局部壓痛的徵狀，少數病患會併發關節邊緣的骨折。由於手部韌帶微小，一般X光片不容易判斷韌帶的損傷程度，我們利用磁振造影加壓姿勢，可以清楚看出韌帶的完整性，對於韌帶損傷的診斷非常有幫助。本案例為一59歲男性，因手指腫脹到院求醫，臨床懷疑拇指尺側側副韌帶斷裂，安排磁振造影檢查。磁振造影除了一般的檢查序列外，還包括加壓姿勢的影像，從加壓姿勢的影像可以清楚看到韌帶斷裂，以及韌帶斷裂所造成的周圍肌腱和關節病變，這些資訊都可以更有力的幫助診斷韌帶損傷。由此例我們可以了解，磁振造影加壓姿勢對於拇指尺側側副韌帶斷裂的臨床診斷，有很大的幫助。

關鍵字

磁振造影 ； 拇指掌指關節 ； 拇指尺側側副韌帶斷裂

並列摘要

Thumb metacarpophalangeal joint is a hinge joint that has contribution to the joint's stability, and in which the average range of motion is 10°-60°. Because thumb metacarpophalangeal joint and proximal interphalangeal joint capsule are loose, it becomes the most common ligament injury of hands. UCL injury causes painful symptoms like swelling and bruising, including restriction of motion. Physicians often utilize imaging techniques such as x-rays and magnetic resonance imaging aid with making a proper diagnosis. This 59-year-old male came to our hospital because of thumb swelling pain. He was arranged to MRI examination because highly suspected UCL injury. From MR stress imaging, we could see pathological changes clearly induced by UCL injury. According to this case, we could know that MR stress position has valuable contribution to help diagnosis.

並列關鍵字

magnetic resonance imaging ； thumb metacarpophalangeal joint ； UCL injury