MR imaging of the wrist frequently represents a diagnostic challenge for radiologists because of the complex anatomy of this joint, small size of its components, and little known pathologic conditions. MR arthrography combines the advantages of conventional MR imaging and arthrography by improving the visualization of small intra-articular abnormalities. This ...

Tumors involving the upper extremity are not uncommon. Although there is a wide variety of lesions that may occur in the hand and wrist, there are certain lesions which have a predilection for this location. This chapter will highlight the spectrum of imaging modalities available for the evaluation of upper ...

Motion of the wrist bones is complicated and difficult to measure. Noninvasive measurement of carpal kinematics using medical images has become popular This technique is difficult and most investigators employ custom software. The objective of this paper is to describe a validated methodology for measuring carpal kinematics from computed tomography ...

OBJECTIVE: The educational objectives of this continuing medical education activity are for the reader to exercise, self-assess, and improve skills in diagnostic radiology with regard to the interpretation of radiographs, CT, and MRI of the hand and to improve understanding of the appropriate use of CT and MRI in evaluating ...

Giant-cell tumour of bone (GCTOB) is a benign, locally aggressive, primary bone tumour. Involvement of the distal radius accounts for between 10 and 12% of cases of GCTOB, with the bones of the hand and wrist being rarely affected. GCTOB most commonly affects skeletally mature patients between the ages of ...

OBJECTIVE: Our objective was to assess the potential use of MDCT in the detection of occult scaphoid fractures. Fifty-one patients with suspected radiographically occult scaphoid fractures at 10-14 days after trauma were investigated prospectively with skeletal scintigraphy and CT on the same day. Planar images of the wrist were taken ...

PURPOSE: To evaluate the feasibility of high-resolution magnetic resonance imaging (MRI) of trabecular bone of the wrist at 3 Tesla (3T) in vivo and to assess the potential benefit of the increased resolution for clinical assessment of structural changes in spongy bone. MATERIAL AND METHODS: High-resolution MRI of the wrist ...

Magnetic resonance imaging (MRI) was performed on the wrists of 103 asymptomatic volunteers. The images were evaluated independently by two musculoskeletal radiologists and one orthopaedic surgeon. Wrist ganglia were identified in 53 out of the 103 wrists. The average long and short axes measurements were 8 mm (range 3-22) and ...

BACKGROUND: Understanding the exact contribution of the supporting ligaments to the functional integrity of the wrist is crucial for the diagnosis and treatment of carpal instabilities. The present study evaluates functional significance of the wrist ligaments with respect to carpal instabilities. MATERIALS AND METHODS: Sixteen fresh cadaver wrists were dissected. ...

Carpal Tunnel Syndrome (CTS) is easily the most common focal peripheral nerve compression. The primary diagnostic tool is electrodiagnosis, although 13-27% of patients with symptoms and signs of CTS have normal electrodiagnostic results. The goal of this study was to create a more sensitive and specific latency difference criteria without ...

OBJECTIVES: By MRI to assess the efficacy of addition of anakinra for controlling synovitis and stopping erosive progression in patients with clinically active RA despite receiving methotrexate, and to determine the predictive value of MRI for subsequent radiographic erosive progression. METHODS: 100 mg anakinra subcutaneously/day was added to the treatment ...

Carpal Tunnel Syndrome (CTS) is the entrapment of Median nerve at wrist. Pregnancy can affect prevalence and severity of CTS. In this study frequency and severity of CTS in pregnancy was evaluated. In this study 100 pregnant women were evaluated by Hand symptoms, CTS provocation tests (Tinel and Phalen) and ...

As a theoretical basis for treatment of carpal tunnel syndrome (CTS) and expanding upon part 1 of this study, the authors investigated the effects of static loading (weights) and dynamic loading (osteopathic manipulation [OM]) on 20 cadaver limbs (10 male, 10 female). This larger study group allowed for comparative analysis ...

This study followed workers over an extended period of time to identify factors which may influence the onset of Carpal Tunnel Syndrome (CTS). The purpose was to evaluate incidence of CTS and to create a predictive model of factors that play a role in the development of CTS. This prospective ...

OBJECTIVE: This study aims to identify the symptoms, signs and distributions which are associated with neurophysiological carpal tunnel syndrome (N-CTS), defined by the finding of a median nerve lesion at the wrist through neurophysiologic studies, and to compare them with those of patients with sensory or motor complaints in the ...

OBJECTIVE: The objective of this study was to measure the prevalence of Chlamydia trachomatis (CT) infection among men in clinical and nonclinical settings across the United States. GOAL: The goal of this study was to obtain data to inform recommendations regarding male CT screening. STUDY: The authors conducted a cross-sectional ...

Inaccurate femoral tunnel placement has been identified as one of the most frequent errors in failed anterior cruciate ligament reconstructions. Most surgeons evaluate the femoral tunnel position on plain radiographs but in a lot of cases it is difficult to detect the femoral tunnel. The goal of this study was ...

BACKGROUND: In carpal tunnel syndrome (CTS), certain changes were expected in sympathetic skin response (SSR) because median nerve carries postganglionic unmyelinated fibres. PURPOSE: To investigate the median and ulnar SSR in idiopathic and diabetic CTS without autonomic dysfunction in hands and to find possible relations with electrophysiological features of these ...

Of 875 idiopathic carpal tunnel syndrome (CTS) cases, 101 (11.5%) required trigger digit release operations within three years before and/or after carpal tunnel release (CTR); these 101 cases were investigated, retrospectively. Trigger digit release (TDR) was performed most often after the CTR, especially within three months. Next most common was ...

OBJECTIVE: To determine the diagnostic value of sonography in patients with suspected carpal tunnel syndrome (CTS). METHODS: We conducted a prospective study of 110 wrists in 74 consecutive patients with suspected CTS who had been referred to a tertiary care center. We determined the largest cross-sectional area of the median ...

There are several different imaging methods that are helpful in the diagnosis of carpal tunnel syndrome, including traditional radiography, computed tomography (CT), and magnetic resonance imaging (MRI). CT and MRI offer the advantage of providing direct visualization of the structural abnormality of the carpal tunnel and median nerve, but both ...

OBJECTIVE: To explore the diagnostic values of 8 commonly used electrodiagnostic techniques for measuring median nerve conduction velocity (NCV) in carpal tunnel syndrome (CTS). DESIGN: Sensitivity and specificity analyses. SETTING: A hospital-based electrodiagnostic laboratory. PARTICIPANTS: Forty-four normal hands and 136 symptomatic hands. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: (1) Long-segment ...

Image latencies occur when a virtual environment (VE) responds to hand movements of its operator. A study has been conducted to investigate the effects of, and interactions among, hand movement related image latencies, target distance, and target width on discrete manual control tasks in a VE. In the presence of ...

PURPOSE: To assess predictive value of a short magnetic resonance (MR) imaging examination in addition to or instead of radiography in patients with acute wrist trauma to identify patients who require additional treatment versus those who do not and can be discharged without further follow-up. MATERIALS AND METHODS: Informed consent ...

An 11-year-old girl with Kienböck disease (stage IIIA) was treated by temporary scaphotrapeziotrapezoidal fixation. It was fixed in a cast for four weeks and wires removed after eight weeks. Follow up examinations showed that movement of the wrist and grip strength were improved, and she had no pain while revascularisation ...

Decompression of the carpal canal is the most common hand surgery performed in the United States. Hand surgeons perform 460,000 carpal tunnel releases (CTR) each year, which cost the medical industry in excess of two billion dollars per year. The focus of this investigation was to identify the changes, which ...

Dislocation or subluxation of the extensor carpi ulnaris (ECU) tendon is one of the differential diagnoses of ulnar-sided wrist pain. No data exists on the degree of subluxation occurring in normal wrists. Retrospective review of surgical cases revealed two patients with dorsal and four with volar instability. Magnetic resonance imaging ...

PURPOSE: To describe the clinical features of patients with a neurophysiologic diagnosis of carpal tunnel syndrome (CTS) in the state of Rio Grande do Sul, Brazil. METHODS: We prospectively studied 1039 patients with a neurophysiologic diagnosis of CTS in southern Brazil. All patients completed a clinicoepidemiological questionnaire which included a ...

Institutional review board approval and informed consent were obtained from 25 healthy volunteers and 15 consecutive patients with chronic wrist pain or suspected carpal mass, and 1.5- and 3-T magnetic resonance (MR) imaging of the wrist was prospectively performed with comparable sequence parameters and surface coils of the same geometric ...

Wrist tendons may be affected by a variety of pathologic conditions, including those caused by trauma and overuse, inflammatory and metabolic disorders, or infection. Sonography is a very sensitive means of detecting tendinous pathology because of its spatial resolution and its comparative and dynamic capabilities. Its wide availability makes it ...

OBJECTIVE: Information is required on levels of agreement between different sets of median nerve conduction studies (NCS) and symptoms of carpal tunnel syndrome (CTS) in at-risk subjects. METHODS: We performed a reanalysis of an extensive data set from a population of 114 "highly exposed" meat workers (without prior diagnosis of ...

OBJECTIVE: Co-registration of bone scintigrams with radiographs has been used in the diagnosis of wrist injuries, although co-registration of tomographic bone scintigraphy with computed tomography (CT) has not been widely reported. We describe a co-registration technique in patients with possible wrist fracture. METHODS: The technique was used on three patients ...

We used the Verhoeff-van Gieson stain method to identify histopathology and to localize elastin in the subsynovial connective tissue of the tendon sheath (SSCT) of the middle finger flexor digitorum superficialis (FDS) within the carpal tunnel in 10 carpal tunnel syndrome (CTS) patients and 10 control cadaver specimens. Normal SSCT ...

OBJECTIVE: In nonoperated patients, the MR diagnosis of carpal tunnel syndrome (CTS) is difficult. In the postoperative patient this difficulty is compounded. Consequently, we sought to evaluate for potential MR signs of postoperative CTS. METHODS: At 1.5 T, 41 wrists in 37 patients with previous CTS release were evaluated by ...

OBJECTIVE: To correlate the anatomic and MR imaging characteristics of the area of intersection of the first and the second dorsal extensor tendon compartments (DETC) in the distal forearm in an attempt to improve the design of MR imaging protocols used for the evaluation of intersection syndrome. DESIGN AND PATIENTS: ...

Carpal Tunnel Syndrome (CTS) is the most common peripheral nerve entrapment. In the diagnosis of Carpal Tunnel Syndrome, velocity is determined by either measuring the average velocity over a segment by dividing the distance by the difference in latencies. Polynomial interpolation can determine the velocity at any point along a ...

BACKGROUND: This study examined whether a state surveillance system for work-related carpal tunnel syndrome (WR-CTS) based on workers' compensation claims (Sentinel Event Notification System for Occupational Risks, SENSOR) and the Annual Survey of Occupational Injuries and Illnesses (SOII) identified the same industries, occupations, sources of injury, and populations for intervention. ...

OBJECTIVE: To relate clinical severity of idiopathic carpal tunnel syndrome (CTS) to current perception threshold (CPT). METHODS: Subjects were 51 patients with CTS (involving 51 hands), and 50 healthy control subjects (50 hands). Involved hands were grouped into three clinical grades (mild, moderate, severe). Using a neurometer (Neurotron, Baltimore, MD), ...

The aim of the present study was to provide French normative data for 112 action line drawings. The set of action pictures consisted of 71 drawings taken from Masterson and Druks (1998) and 41 additional drawings. It was standardized on six psycholinguistic variables--that is, name agreement, image agreement, image variability, ...

OBJECTIVE: The aim of this study was to evaluate the roles of contrast-enhanced dynamic and static magnetic resonance imaging (MRI) and quantitative 99Tcm-labelled nanocolloid (NC) scintigraphy in detecting wrist joint inflammation in early rheumatoid arthritis (RA) patients. METHODS: Twenty-eight early RA patients (median symptom duration 5 months, range 1-12 months) ...

BACKGROUND: The accuracy of diagnostic imaging modalities that are currently used to evaluate dynamic scapholunate ligamentous instability is equivocal. Ultrasound is commonly used for a wide variety of diagnostic purposes in orthopaedics. The purpose of the present study was to determine the efficacy of ultrasound in the diagnosis of dynamic ...

OBJECTIVE: To evaluate gadolinium-enhanced MR imaging in athletes with chronic groin pain and correlate with the clinical features. DESIGN AND PATIENTS: MR examinations performed in 52 athletes (51 male, 1 female; median age 26 years) with chronic groin pain and 6 asymptomatic control athletes (6 male; median age 29 years) ...

A median motor nerve latency (DML) is generally prolonged in the carpal tunnel syndrome (CTS) of hemodialysis patients. Meanwhile, the advanced glycation process of proteins has been reported to be involved in the pathogenesis of the dialysis related amyloidosis. To investigate the role of carboxymethylation in dialysis related CTS, we ...

BACKGROUND: It has been suggested that many patients with carpal tunnel syndrome have associated thyroid or other metabolic diseases. METHODS: 206 patients with clinical features suggestive of carpal tunnel syndrome (CTS), including those with known underlying cause of CTS, were screened for thyroid dysfunction. Nerve conduction studies were compatible with ...

The morphology and positioning of the carpal bones were studied in three dimensions in 18 normal adults on computed tomography (CT) scans of the wrist. The digital data from each CT scan were processed to extract the carpal bones and to automatically characterize their geometry (geometric centroid, principal axes of ...

BACKGROUND: The delta phalanx, also known as the delta bone, or longitudinal epiphyseal bracket (LEB), has been described in a variety of syndromes and dysplasias. However, the "kissing delta phalanx" is not as well recognized in the literature; it consists of a duplicated longitudinal bracketed epiphysis, or a complex of ...

OBJECTIVE: To determine the utility of the flick maneuver (flicking motion of hands and wrists when most symptomatic) in the clinical evaluation of carpal tunnel syndrome (CTS). DESIGN: Review of standardized data collection on 142 subjects referred for electrodiagnostic evaluation of possible CTS at a university hospital electrodiagnostic clinic. Subjects ...

PURPOSE: To identify predictors of outcome and of electrophysiologic recovery in patients with carpal tunnel syndrome (CTS) treated by endoscopic carpal tunnel release using a nerve conduction testing system (NC-Stat; NEUROMetrix, Inc, Waltham, MA). METHODS: Validity of the automated nerve conduction testing system was shown by comparing presurgical distal motor ...

A 68-year-old man with adult-onset diabetes mellitus suffered an accidental puncture wound to the palm of his hand while playing with his pet dog. He received cephalosporin prophylaxis for 1 week. No inflammation occurred. Six months later, a mass developed near his elbow. It was removed. Histopathology revealed granulomas containing ...

BACKGROUND: We undertook a literature review to produce evidence-based recommendations for nonsurgical family physician management of carpal tunnel syndrome (CTS). METHODS: Study design was systematic review of randomized controlled trials (RCTs) on CTS treatment. Data sources were English publications from all relevant databases, hand searches, and guidelines. Outcomes measured were ...