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腕关节造影:操作方法及正常结果(作者译)

[Arthrography of the wrist: procedures and normal results (author's transl)].

作者信息

Metges P J, Kleitz C, Vermeulin G, Delahaye R P

出版信息

J Radiol. 1979 Apr;60(4):239-49.

PMID:314980
Abstract

The results of 31 opaque arthrographies of the wrist carried out under two different circumstances are reported. --In a first group the investigation was made immediately after or within a longer period following injury to the wrist or forearm. The results supply information to the surgeon on the condition of the triangular ligament in dislocation and partial dislocations of the inferior radioulnar joint, caused by an architectural fault in the radius after trauma (fracture of the head, diaphysis, or lower extremity). Simple reduction of the radius, without intervention on the inferior radio-ulnar joint, provides an excellent functional result when the triangular ligament is simply stretched. When it is torn (sprains, dislocation locally or at a distance) results are not very convincing in spite of the many possible procedures available. Arthrography easily reveals the presence of a reflex dystrophy complicating the injury. Both the radiological and clinical signs give characteristic pictures of the condition. --This examination is still only used infrequently for the diagnosis of chronic inflammatory rheumatic diseases. The arthrographic images appear very early, however, and are characteristic of an inflammatory synovial lesion. Examinations were carried out mainly for evaluation before therapy, surgical in the case of a synovectomy, medical for a chemical or isotopic synovial treatment. Arthrography in a acutely inflammed joint is followed by an injection of corticoid, sometimes associated with a local antibiotic. This rapidly relieves the patient and prevents worsening of the acute inflammatory process. Arthrography of the wrist is a simple, painless, rapidly performed examination. There has never been a failure, any incident, or accident. It appears to be the only direct exploratory procedure for this joint. A precise anatomical evaluation can be made from the image which gives a true picture of the different anatomical structures.

摘要

本文报告了在两种不同情况下对31例腕关节进行的不透明关节造影结果。——在第一组中,检查是在手腕或前臂受伤后立即或在较长一段时间内进行的。这些结果为外科医生提供了有关下尺桡关节脱位和部分脱位时三角韧带状况的信息,这些脱位是由创伤后桡骨结构缺陷(头部、骨干或下肢骨折)引起的。当三角韧带只是被拉伸时,单纯复位桡骨而不干预下尺桡关节,能取得良好的功能结果。当韧带撕裂(扭伤、局部或远距离脱位)时,尽管有许多可行的手术方法,但结果并不十分令人满意。关节造影很容易发现损伤并发反射性交感神经营养不良的情况。放射学和临床体征都给出了该病的特征性表现。——这种检查在慢性炎症性风湿性疾病的诊断中仍很少使用。然而,关节造影图像出现得很早,是炎症性滑膜病变的特征。检查主要是为了在治疗前进行评估,对于滑膜切除术采用手术治疗,对于化学或同位素滑膜治疗采用药物治疗。在急性炎症关节进行关节造影后注射皮质类固醇,有时联合局部抗生素。这能迅速缓解患者症状并防止急性炎症过程恶化。腕关节造影是一种简单、无痛、操作迅速的检查。从未出现过失败、任何意外或事故。它似乎是对该关节唯一的直接探查方法。可以从图像中进行精确的解剖学评估,该图像能真实呈现不同的解剖结构。

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