Kim Kyeongwon, Kim Min-Wook
Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
Ann Rehabil Med. 2017 Aug;41(4):709-714. doi: 10.5535/arm.2017.41.4.709. Epub 2017 Aug 31.
Lunate and perilunate dislocations are uncommon, but they have clinical importance because complications, such as median neuropathy and avascular necrosis of the lunate, can occur. Although early diagnosis enabling early surgical treatment is crucial for preventing long-term sequelae, these dislocations are frequently missed in the initial assessment. Imaging tools, such as plain radiography, magnetic resonance imaging, ultrasonography, and electrodiagnostic studies, have been used for diagnosis. The proper choice of initial evaluation tools is important for making an accurate early diagnosis. Here we present a case of lunate dislocation associated with median neuropathy in which ultrasonography, along with the electrodiagnostic study and plain radiography, played an important diagnostic role in detecting structural abnormalities. This case report reveals the complementary diagnostic role of ultrasonography in initial assessment and provides ultrasonographic images of lunate dislocation as a cause of median neuropathy.
月骨和月周脱位并不常见，但因其可能引发如正中神经病变和月骨缺血性坏死等并发症而具有临床重要性。尽管早期诊断并尽早进行手术治疗对于预防长期后遗症至关重要，但这些脱位在初始评估中常常被漏诊。诸如X线平片、磁共振成像、超声检查以及电诊断研究等影像学工具已被用于诊断。正确选择初始评估工具对于准确的早期诊断很重要。在此，我们报告一例伴有正中神经病变的月骨脱位病例，其中超声检查与电诊断研究及X线平片一起，在检测结构异常方面发挥了重要的诊断作用。本病例报告揭示了超声检查在初始评估中的互补诊断作用，并提供了作为正中神经病变病因的月骨脱位的超声图像。
