Couzens Greg, Daunt Nick, Crawford Ross, Ross Mark
Brisbane Hand and Upper Limb Research Institute, Brisbane Private Hospital, Brisbane, Queensland, Australia; Department of Orthopaedics, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
ANZ J Surg. 2014 Jul-Aug;84(7-8):528-32. doi: 10.1111/ans.12552. Epub 2014 Feb 26.
Magnetic resonance imaging (MRI) is being increasingly utilized to define pathology and guide treatment in patients presenting with wrist pain. The clinical relevance of MRI identified or confirmed pathology has not been established, and the prevalence of asymptomatic MRI pathology is not known.
Twenty volunteers with no previous wrist injury or symptoms underwent bilateral MRI wrist studies in this exploratory diagnostic study. The scans were reported by an experienced musculoskeletal radiologist and an experienced wrist surgeon, with a consensus reached on each report.
There were 3.15 positive MRI findings per wrist. There were 126 positive findings (range 1-6 per wrist). Sixty-eight ganglia were identified. Eleven ligament tears or perforations were also identified. Increased joint fluid was seen at many sites, most frequently adjacent to the piso-triquetral joint.
The accuracy of MRI in identifying triangular fibrocartilage complex tears, intercarpal ligament tears and carpal bone osteonecrosis is rapidly being refined. Positive MRI findings are common and may be coincidental in patients with wrist pain. MRI findings need to be correlated closely with clinical examination and history.
磁共振成像（MRI）越来越多地用于确定手腕疼痛患者的病理情况并指导治疗。MRI所识别或确认的病理情况的临床相关性尚未明确，无症状MRI病理情况的患病率也未知。
在这项探索性诊断研究中，20名既往无手腕损伤或症状的志愿者接受了双侧手腕MRI检查。扫描结果由一名经验丰富的肌肉骨骼放射科医生和一名经验丰富的手腕外科医生报告，每份报告达成共识。
每只手腕有3.15个MRI阳性发现。共有126个阳性发现（每只手腕1 - 6个）。识别出68个腱鞘囊肿。还识别出11处韧带撕裂或穿孔。在许多部位可见关节液增多，最常见于豌豆三角骨间关节附近。
MRI在识别三角纤维软骨复合体撕裂、腕骨间韧带撕裂和腕骨骨坏死方面的准确性正在迅速提高。MRI阳性发现在手腕疼痛患者中很常见，可能是巧合。MRI结果需要与临床检查和病史密切相关。
