MRI of the Intrinsic Muscles of the Hand: Spectrum of Imaging Findings and Clinical Correlation

Andreisek, Gustav; Kilgus, M.; Burg, Doris; Saupe, Nadja; Crook, David; Meyer, Viktor E.; Marinček, Borut; Weishaupt, Dominik

doi:10.2214/ajr.04.1644

Cited by 13 publications

(7 citation statements)

References 36 publications

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“…The accuracy of observers and the interobserver agreement in MRI depends on the type of lesion in the hand and wrist, and may vary even in experienced radiologists [4,5]. In a recent pilot study, it was demonstrated that SPECT/CT is more specific than MRI concerning the detection of clinically relevant lesions in patients with non-specific wrist pain [6].…”

Section: Introductionmentioning

confidence: 99%

Imaging Non-Specific Wrist Pain: Interobserver Agreement and Diagnostic Accuracy of SPECT/CT, MRI, CT, Bone Scan and Plain Radiographs

et al. 2013

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PurposeChronic hand and wrist pain is a common clinical issue for orthopaedic surgeons and rheumatologists. The purpose of this study was 1. To analyze the interobserver agreement of SPECT/CT, MRI, CT, bone scan and plain radiographs in patients with non-specific pain of the hand and wrist, and 2. to assess the diagnostic accuracy of these imaging methods in this selected patient population.Materials and MethodsThirty-two consecutive patients with non-specific pain of the hand or wrist were evaluated retrospectively. All patients had been imaged by plain radiographs, planar early-phase imaging (bone scan), late-phase imaging (SPECT/CT including bone scan and CT), and MRI. Two experienced and two inexperienced readers analyzed the images with a standardized read-out protocol. Reading criteria were lesion detection and localisation, type and etiology of the underlying pathology. Diagnostic accuracy and interobserver agreement were determined for all readers and imaging modalities. ResultsThe most accurate modality for experienced readers was SPECT/CT (accuracy 77%), followed by MRI (56%). The best performing, though little accurate modality for inexperienced readers was also SPECT/CT (44%), followed by MRI and bone scan (38% each). The interobserver agreement of experienced readers was generally high in SPECT/CT concerning lesion detection (kappa 0.93, MRI 0.72), localisation (kappa 0.91, MRI 0.75) and etiology (kappa 0.85, MRI 0.74), while MRI yielded better results on typification of lesions (kappa 0.75, SPECT/CT 0.69). There was poor agreement between experienced and inexperienced readers in SPECT/CT and MRI. ConclusionsSPECT/CT proved to be the most helpful imaging modality in patients with non-specific wrist pain. The method was found reliable, providing high interobserver agreement, being outperformed by MRI only concerning the typification of lesions. We believe it is beneficial to integrate SPECT/CT into the diagnostic imaging algorithm of chronic wrist pain.

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Section: Introductionmentioning

confidence: 99%

Imaging Non-Specific Wrist Pain: Interobserver Agreement and Diagnostic Accuracy of SPECT/CT, MRI, CT, Bone Scan and Plain Radiographs

et al. 2013

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“…The ulnar nerve passes through the Guyon canal in the wrist, and many lesions may affect the ulnar nerve at this site, such as ganglion cysts, nerve sheath tumors, repetitive trauma, or hamate fractures (Fig 12) (71). MR imaging is useful in identifying the underlying cause of the compression, but the sensitivity and specificity have not been reported, to our knowledge (72).…”

Section: Nerve Lesions and Compression Neuropathiesmentioning

confidence: 82%

Clinical Orthopedic Examination Findings in the Upper Extremity: Correlation with Imaging Studies and Diagnostic Efficacy

Pandey¹,

Slaughter²,

Reynolds³

et al. 2014

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Different orthopedic tests are used to evaluate internal derangements of joints. Radiologic examinations like magnetic resonance (MR) imaging are ordered on the basis of results of these tests to narrow the clinical diagnosis and formulate a treatment plan. Although these tests are clinically useful, the test terminology can be confusing and the significance of the tests not clearly understood. This article helps explain the clinical jargon of tests performed for the major joints of the upper extremity and their proper use and diagnostic value in conjunction with MR imaging. The article presents a structured algorithmic approach to explain the tests. For each joint, a hierarchy of clinical tests is performed, starting with general observation and range of motion, followed by more specific tests tailored to evaluate individual or grouped anatomic structures. MR imaging findings and clinical tests complement each other in making a final diagnosis. However, because of the varied sensitivity and specificity of the clinical tests and MR imaging, it is important to be familiar with their diagnostic value before making clinical decisions. Knowledge of clinical jargon and the proper use and diagnostic value of orthopedic tests can aid in interpretation of radiologic images by focusing search patterns, thus allowing comprehensive evaluation and optimized reporting. It also enhances communication with the orthopedist, thereby helping maintain continuity of care. Online supplemental material is available for this article.

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“…Several tumors may affect the intrinsic muscles of the hand. 11,14,43 A comprehensive review article was published in 2014 by Lee and Tandon. 44 They describe typical imaging features of focal lesions of the hand including several benign, malignant, and indeterminate lesions.…”

Section: Tumorsmentioning

confidence: 99%

“…A study by Andreisek et al in 19 patients with clinically evident or suspected intrinsic hand muscle abnormalities showed that MR imaging of the hand is useful and correlates well with clinical findings in patients with posttraumatic syndromes, peripheral neuropathies, myositis, and tumorous lesions, as well as congenital abnormalities. 14,15 Because there is sparse literature on the intrinsic muscles of the hand, this review article offers a comprehensive review of muscle function and anatomy, describes normal MR imaging anatomy, and shows a spectrum of abnormal imaging findings.…”

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confidence: 99%