Ichinose Hirofusa, Nakamura Ryogo, Nakao Etsuhiro, Shinohara Takaaki, Tatebe Masahiro, Yamada Harumoto
Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Nagoya Hand Center, Chunichi Hospital, Ngoya, Japan.
J Wrist Surg. 2018 Nov;7(5):389-393. doi: 10.1055/s-0038-1661420. Epub 2018 Jul 2.
Wrist swelling is a frequent clinical manifestation of Kienböck's disease, but no study has reported the site and pathology of wrist swelling in this disease. The aim of this study is to elucidate the site and pathology of wrist swelling in Kienböck's disease. Dorsal and palmar soft tissue thicknesses of the wrist were measured on standard lateral radiographs of the wrist in 26 patients with Kienböck's disease and 30 subjects without intra-articular lesion. Axial magnetic resonance imaging (MRI) views were examined to detect the site of swelling. The dorsal capsular ligament in three patients with Kienböck's disease underwent histological examination. Radiographic study confirmed dorsal wrist swelling in 24 of 26 (92%) patients examined compared with the contralateral unaffected wrists. MRI demonstrated thickening of the dorsal capsular ligament and extensor layer with synovial proliferation. Histological examination revealed nonspecific chronic inflammation. Dorsal wrist swelling in Kienböck's disease is a common manifestation and constitutes a part of pathology of Kienböck's disease, although further study is required to clarify the relation between wrist swelling and etiology of Kienböck's disease. This is a Level III study.
腕部肿胀是月骨无菌性坏死的常见临床表现，但尚无研究报道该病腕部肿胀的部位及病理情况。本研究旨在阐明月骨无菌性坏死时腕部肿胀的部位及病理情况。 在26例月骨无菌性坏死患者和30例无关节内病变的受试者的标准腕关节侧位X线片上测量腕部背侧和掌侧软组织厚度。检查轴位磁共振成像（MRI）图像以检测肿胀部位。对3例月骨无菌性坏死患者的背侧关节囊韧带进行组织学检查。 X线片研究证实，与对侧未受累腕部相比，26例受检患者中有24例（92%）存在腕部背侧肿胀。MRI显示背侧关节囊韧带和伸肌层增厚，伴有滑膜增生。组织学检查显示为非特异性慢性炎症。 月骨无菌性坏死时腕部背侧肿胀是一种常见表现，构成了月骨无菌性坏死病理的一部分，尽管需要进一步研究以阐明腕部肿胀与月骨无菌性坏死病因之间的关系。 本研究为III级研究。
