Nance Erin M, Byun David J, Endo Yoshimi, Wolfe Scott W, Lee Steve K
Hospital for Special Surgery, New York, New York.
Department of Radiology, Weill Cornell Medical College, New York, New York.
J Wrist Surg. 2017 Nov;6(4):276-279. doi: 10.1055/s-0037-1599829. Epub 2017 Mar 8.
The etiology of dorsal wrist pain associated with loading of the wrist in extension has not been clearly identified in the literature. Many exercise disciplines incorporate upper extremity weight-bearing exercises in an extended wrist posture, for example push-ups, plank position, and various yoga and Pilates poses. This study evaluates patients with dorsal wrist pain in the extended wrist-loading position and identifies anatomic abnormalities in the wrist using magnetic resonance imaging (MRI). A retrospective chart review was performed comparing MRI of patients who complained of dorsal wrist pain while performing weight bearing in a wrist extension position with a control group of patients who complained of ulnar-sided wrist pain. The primary MRI outcome was dorsal wrist pathology, including occult dorsal ganglion cyst, scapholunate ligament tear or degeneration, and dorsal capsulitis. Dorsal wrist pathology was significantly more prevalent in patients with dorsal wrist pain (84%) than in the patient cohort with ulnar-sided wrist pain (12%). Occult dorsal ganglion cysts were the most common sources of pathology (76%). MRI demonstrated an identifiable dorsal abnormality in 84% of patients with dorsal wrist pain associated with weight bearing on the extended wrist. Occult dorsal ganglion cysts are the most common cause of dorsal wrist pain, followed by partial scapholunate tears. When patients complain of dorsal wrist pain during specific extended loading wrist positions such as push-ups, yoga, or Pilates poses, an MRI may be warranted to help identify anatomic abnormalities that may help guide treatment choices. Diagnostic, Level III.
文献中尚未明确确定与腕关节伸展负重相关的腕背疼痛的病因。许多运动项目都包含上肢负重练习，且腕关节处于伸展姿势，例如俯卧撑、平板支撑姿势以及各种瑜伽和普拉提姿势。本研究对处于腕关节伸展负重姿势时出现腕背疼痛的患者进行评估，并使用磁共振成像（MRI）确定腕关节的解剖异常。进行了一项回顾性病历审查，比较了在腕关节伸展位进行负重时主诉腕背疼痛的患者与主诉尺侧腕关节疼痛的对照组患者的MRI。主要的MRI结果是腕背病变，包括隐匿性背侧腱鞘囊肿、舟月韧带撕裂或退变以及背侧囊炎。腕背病变在腕背疼痛患者中（84%）比尺侧腕关节疼痛患者队列中（12%）更为普遍。隐匿性背侧腱鞘囊肿是最常见的病变来源（76%）。MRI显示，84%的与伸展腕关节负重相关的腕背疼痛患者存在可识别的背侧异常。隐匿性背侧腱鞘囊肿是腕背疼痛最常见的原因，其次是舟月韧带部分撕裂。当患者在特定的伸展负重腕关节姿势（如俯卧撑、瑜伽或普拉提姿势）期间主诉腕背疼痛时，可能需要进行MRI检查，以帮助识别可能有助于指导治疗选择的解剖异常。诊断性研究，III级。
