Cerezal Luis, del Piñal Francisco, Abascal Faustino, García-Valtuille Roberto, Pereda Teresa, Canga Ana
Department of Radiology, Instituto Radiológico Cántabro, Clínica Mompía, Mompía, 39100 Cantabria, Spain.
Radiographics. 2002 Jan-Feb;22(1):105-21. doi: 10.1148/radiographics.22.1.g02ja01105.
Impaction syndromes related to ulnar-sided pain include ulnar impaction syndrome, ulnar impingement syndrome, ulnocarpal impaction syndrome secondary to nonunion of the ulnar styloid process, ulnar styloid impaction syndrome, and hamatolunate impingement syndrome. The most common of these, ulnar impaction syndrome, is a degenerative condition of the ulnar side of the wrist related to excessive load bearing across the ulnar carpus, triangular fibrocartilage (TFC) complex, and ulnar head. In an adequate clinical setting, characteristic osseous findings at radiography include positive ulnar variance in ulnar impaction syndrome, a short ulna in ulnar impingement syndrome, nonunion of the ulnar styloid process in ulnar impaction syndrome secondary to ulnar styloid nonunion, an excessively long ulnar styloid process in ulnar styloid impaction syndrome, and type II lunate bone in hamatolunate impingement syndrome. Nevertheless, confirmation of clinical and conventional radiographic findings with magnetic resonance (MR) imaging is often necessary to exclude other entities with similar clinical manifestations. MR imaging allows earlier detection of an abnormality in the TFC complex, cartilage, or bone marrow of carpal bones and is helpful in formulating the extensive differential diagnosis in patients with ulnar wrist pain and limitation of motion.
与尺侧疼痛相关的撞击综合征包括尺骨撞击综合征、尺骨撞击症、尺骨茎突不愈合继发的尺腕撞击综合征、尺骨茎突撞击综合征和钩月骨撞击综合征。其中最常见的尺骨撞击综合征是一种腕关节尺侧的退行性疾病，与通过尺侧腕骨、三角纤维软骨（TFC）复合体和尺骨头的过度负重有关。在适当的临床情况下，X线摄影的特征性骨质表现包括尺骨撞击综合征中的阳性尺骨变异、尺骨撞击症中的尺骨短缩、尺骨茎突不愈合继发的尺骨撞击综合征中的尺骨茎突不愈合、尺骨茎突撞击综合征中的尺骨茎突过长以及钩月骨撞击综合征中的II型月骨。然而，通常需要磁共振（MR）成像来证实临床和传统X线摄影的发现，以排除具有相似临床表现的其他疾病。MR成像能够更早地检测到TFC复合体、软骨或腕骨骨髓中的异常，有助于对尺侧腕关节疼痛和活动受限的患者进行广泛的鉴别诊断。
