Imaging of Sports-related Hand and Wrist Injuries: Sports Imaging Series

Abstract

Hand and wrist injuries are common occurrences in amateur and professional sports and many of them are sport-specific. These can be divided into two categories: traumatic injuries and overuse injuries. The aim of this article is to review the most common hand and wrist sports-related lesions. Acute wrist injuries are predominantly bone fractures, such as those of the scaphoid, hamate hook, and ulnar styloid. Ligament lesions are more challenging for radiologists and may lead to carpal instability if undiagnosed. Overuse wrist injuries are mainly represented by tendinous disorders, with De Quervain syndrome and extensor carpi ulnaris tendon disorders being the most common among them; however, there are other possible disorders such as impaction syndromes, stress fractures, and neurovascular lesions. Finally, finger lesions, including closed-tendon injuries (mallet and boutonniere injuries, jersey finger, and boxer's knuckle), flexor pulley injuries, and skier's thumb, should also be detected. (©) RSNA, 2016 Online supplemental material is available for this article.

Hook of the Hamate: The Spectrum of Often Missed Pathologic Findings

“…However, images in these standard views poorly show the hook of the hamate. Additional special projections for the hook of the hamate include the semi-supinated oblique view, carpal tunnel view, and lateral view with thumb abduction and radial deviation of the hand [9]. Despite best efforts, some patients are unable to tolerate the positions required for these special views because of pain [5].…”

“…Fractures involving the hook are the most common type of hamate fracture [2]. The incidence of hook of the hamate fractures among professional and recreational athletes is much higher than in the general population and is posited to be on the rise owing to the increasing popularity of golf and racket sports [9, 12]. Several mechanisms cause hook of the hamate fractures, including blunt trauma, repetitive microtrauma, and avulsion injury.…”

“…Fall on an outstretched hand, motor vehicle collision, and direct strike from a projectile such as a baseball are common causes of acute traumatic fracture [7, 13, 14]. Gripping-related acute trauma to the hook when holding a bat, racket, golf club, or bicycle handle is an additional common mechanism [7, 9, 15] (Fig. 2A).…”

“…2B). Avulsion fractures occur as the result of ligamentous or tendinous forces tugging on the hook [9]. …”

“…Ring- and small-finger paresthesias have been reported with acute and chronic fractures [11, 13]. The site of maximal pain may be misleading at physical examination, and localizing signs directly attributable to the hook of the hamate are often difficult to detect [9, 11]. Presence of the Tinel sign at the hypothenar region should raise clinical suspicion of the presence of a hook fracture [7].…”