Department of Radiology, LMU, Munich, Germany.
Department of Radiology, University Hospital Würzburg, Würzburg, Germany.
Semin Musculoskelet Radiol. 2021 Apr;25(2):304-310. doi: 10.1055/s-0041-1730398. Epub 2021 Aug 9.
Beyond clinical examination, the various forms of carpal instability are assessed with radiologic methods and arthroscopy. For this purpose, the imaging demand for spatial and contrast resolution is particularly high because of the small ligamentous structures involved. The entities of carpal instability are classified into degrees of severity. Early (dynamic) forms of instability can either be indirectly detected with X-ray stress views and cineradiography or by direct visualization of ruptured ligaments in high-resolution magnetic resonance (MR) imaging and MR or computed tomography (CT) arthrography, with the latter the standard of reference in imaging. Advanced (static) forms of carpal instability are sufficiently well detected on radiographs; visualization of early carpal osteoarthritis is superior on CT. To prevent disability of the hand, the radiologist has to provide an early and precise diagnosis. This case-based review highlights the imaging procedures suitable for detection and classification of carpal instability.
除了临床检查，腕关节不稳定的各种形式还可以通过放射学方法和关节镜进行评估。为此，由于涉及到小的韧带结构，对空间和对比分辨率的成像要求特别高。腕关节不稳定的实体根据严重程度进行分类。早期（动态）不稳定形式可以通过 X 射线应力视图和电影透视间接检测，也可以通过高分辨率磁共振成像（MR）和 MR 或计算机断层扫描（CT）关节造影直接观察韧带破裂，后者是影像学的参考标准。晚期（静态）腕关节不稳定在 X 光片上检测效果良好；CT 对早期腕骨关节炎的可视化效果更好。为了防止手部残疾，放射科医生必须提供早期和准确的诊断。本案例回顾强调了适合检测和分类腕关节不稳定的成像程序。
