Zmiany patologiczne ręki w badaniu ultrasonograficznym

Abstract

Everyday medical practice shows that most common problems within the hand result from overload, injuries and degeneration. Dorsal side pathologies such as de Quervain's and Wartenberg's disease, intersection syndrome or degenerative lesions of carpometa-carpal joint of the thumb discussed in the paper can be accurately diagnosed and differentiated by means of ultrasound examination. Ultrasound is similarly powerful in detection and grading of traumatic lesions involving extensor tendons and their sagittal bands or the flexor tendons and their pulleys. In the case of carpal tunnel syndrome one can not only visualize the median nerve but also other structures of the tunnel that may cause compression. Similarly ulnar nerve compression within the Guyon's canal can be well evaluated. In cases of nerve trauma one can precisely define the level, and in cases of nerve discontinuity, the distance between stumps can be measured which is important in surgery planning. Often nerve trauma is a sequelae of tendon reconstruction. In such cases scars and nerve entrapment can be depicted. Tumors within a hand are usually benign, of which the most common are ganglia. On ultrasound examination a connection between a ganglion and its source (usually a joint or sheath) can frequently be defined. The relationship of tumors to nerves, tendon sheaths or vessels may suggest their nature. Ultrasound with dynamic tissue assessment is a very valuable adjunct to clinical examination.

Ultrasound-guided methotrexate injection for De Quervain disease of the wrist: what lies beyond the horizon?

“…DQVD affects 0.5% of working men and 1.3% of working women. 7 Pregnancy, early motherhood, and postmenopausal status predispose women to the development of DQVD. 8 Frequently, DQVD involves the dominant hand; however, involvement of the non-dominant hand is also encountered in clinical practice.…”

Radial sesamoid fracture of the second MCP joint – a case report

“…The method is cost-effective, available and above all safe to the patient. Its use in differential diagnosis is dependent on the operator's experience, an in-depth anatomical knowledge of musculoskeletal system and on the class of the equipment ( 7 ) .…”

Wrist ultrasound examination – scanning technique and ultrasound anatomy. Part 1: Dorsal wrist

“…Fibrosis and thickening of the retinaculum of the first compartment result from the inflammatory-repair reaction. These conditions exacerbate the conflict between the tendons/sheaths and the pulley that move beneath it, and can ultimately lead to the blockage of tendon movement ( 6 ) .…”

“…In advanced stages, a US image shows changes within the tendons themselves, i.e. thickening, blurred fibrillar structure or vascularized scars ( 6 ) . The presence of anechoic zones within the tendons, without increased vascularity in patients with a long history, probably indicates hypocellular scarring ( 6 ) .…”

“…In patients with these symptoms, the nerve echostructure must be assessed along its entire length on transverse and longitudinal views, with particular attention paid to edema, rupture or significant changes in adjacent tissues (e.g. thrombosis in the cephalic vein) ( 6 ) . The identification of the radial nerve branches and vessels is important before each intervention, e.g.…”