Erkin Gülten, Uysal Hilmi, Keleş Işik, Aybay Canan, Ozel Sumru
Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ministry of Health, Ankara, Turkey.
Rheumatol Int. 2006 Dec;27(2):191-6. doi: 10.1007/s00296-006-0166-8. Epub 2006 Aug 2.
Acute ulnar neuropathy at the wrist is an extremely uncommon condition, at times requiring a high index of suspicion for the diagnosis. Clinical presentations of ulnar nerve lesions at the wrist and hand show variations due to the complex anatomic course of the nerve in distal sites. We report a case of acute ulnar neuropathy at the wrist caused by a ganglion in Guyon's canal, being initially misinterpreted as flexor tenosynovitis. The accurate diagnosis of selective distal motor neuropathy of ulnar nerve was made electrophysiologically. Magnetic resonance imaging revealed a well defined soft tissue mass consistent with a ganglion, compressing the ulnar nerve in Guyon's canal. Entrapment neuropathies are one of the common conditions handled by physiatrists. Ulnar nerve lesions at the wrist should be kept in mind in the differential diagnosis of patients with wrist or hand pain. Magnetic resonance imaging is a useful method in the anatomical evaluation of acute focal neuropathies.
腕部急性尺神经病变极为罕见，有时诊断需要高度的怀疑指数。由于神经在远端部位的解剖行程复杂，腕部和手部尺神经损伤的临床表现存在差异。我们报告一例由Guyon管内腱鞘囊肿引起的腕部急性尺神经病变，最初被误诊为屈指腱鞘炎。通过电生理检查准确诊断为尺神经选择性远端运动神经病变。磁共振成像显示一个边界清晰的软组织肿块，符合腱鞘囊肿，压迫Guyon管内的尺神经。卡压性神经病变是物理治疗师处理的常见病症之一。在诊断手腕或手部疼痛的患者时，应考虑腕部尺神经损伤。磁共振成像在急性局灶性神经病变的解剖学评估中是一种有用的方法。
