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The current role of high-resolution ultrasonography of the hand and wrist in rheumatic diseases.
Clinical and Experimental Rheumatology 1998 July
OBJECTIVE: To assess the current role of ultrasound in the diagnosis and treatment of pathological changes in the wrist and hand.
METHODS: 39 patients (14 male and 25 female, mean age 35 yrs.) with ill-defined pain and/or swelling of the wrist or hand were examined using a high-definition ultrasound (US) instrument.
RESULTS: 18 patients had tenosynovitis, which in one patient was due to a previously unsuspected foreign body. 10 patients had arthritis involving the wrist and 5 the fingers; 2 patients had a ganglion; one had a neuroma of the median nerve and one patient with a previous tenorrhaphy suffered from the recurrent rupture of this tendon. Two patients had carpal tunnel syndrome, one due to tenosynovitis and one due to the formation of a post-operative fibrotic sheath around the median nerve. 7 patients with synovitis of the wrist underwent US-guided synovial biopsy. 12 patients with tenosynovitis and 6 with arthritis received injections of corticosteroids plus anaesthetic under US-guidance. The spreading of the steroid crystals around the tendon and throughout the joint could be easily monitored. No complications were encountered.
CONCLUSION: High-definition ultrasound is a valuable technique for the imaging of pathologic changes of the wrist and hand and for injection therapy.
METHODS: 39 patients (14 male and 25 female, mean age 35 yrs.) with ill-defined pain and/or swelling of the wrist or hand were examined using a high-definition ultrasound (US) instrument.
RESULTS: 18 patients had tenosynovitis, which in one patient was due to a previously unsuspected foreign body. 10 patients had arthritis involving the wrist and 5 the fingers; 2 patients had a ganglion; one had a neuroma of the median nerve and one patient with a previous tenorrhaphy suffered from the recurrent rupture of this tendon. Two patients had carpal tunnel syndrome, one due to tenosynovitis and one due to the formation of a post-operative fibrotic sheath around the median nerve. 7 patients with synovitis of the wrist underwent US-guided synovial biopsy. 12 patients with tenosynovitis and 6 with arthritis received injections of corticosteroids plus anaesthetic under US-guidance. The spreading of the steroid crystals around the tendon and throughout the joint could be easily monitored. No complications were encountered.
CONCLUSION: High-definition ultrasound is a valuable technique for the imaging of pathologic changes of the wrist and hand and for injection therapy.
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