Akdag Tuba, Turan Aynur, Ayhan Egemen, Bas Can Emre, Hekimoğlu Baki
Department of Radiology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Irfan Bastug Street, Ankara, Turkey.
Division of Hand Surgery, Department of Orthopaedics and Traumatology, University of Health Sciences, Diskapi Yildirim Beyazit Training and Research Hospital, Irfan Bastug Street, Ankara, Turkey.
Indian J Orthop. 2021 Nov 29;56(4):628-633. doi: 10.1007/s43465-021-00530-2. eCollection 2022 Apr.
This study aimed to determine the radial styloid osseous changes observed on posteroanterior wrist radiographs of patients with de Quervain's tenosynovitis who required surgery or conservative treatment.
The surgically treated group included 24 patients with de Quervain's tenosynovitis. The conservative treatment group and the healthy control group each comprised 24 age- and sex-matched subjects. We evaluated the presence of bone apposition, periosteal reaction, sclerosis, osteopenia, erosion, and contour bulge in the epiphyseal remnant at the radial styloid. The incidences of abnormal radiographic findings were compared between these three groups. The correlation of radial styloid bony changes with the duration of symptoms was also analyzed.
No significant differences were found between the three groups in terms of periosteal reaction, erosion, and contour bulge at the epiphysial remnant. Significant differences were found between the three groups in the incidence of bone apposition, sclerosis, and osteopenia ( < 0.001). Bone apposition incidence in the surgically and conservatively treated groups was significantly higher than that in the control group ( < 0.001). Sclerosis and osteopenia significantly differed between the surgically and conservatively treated groups ( < 0.001, = 0.002, respectively). No significant association was observed between the duration of symptoms and the radial styloid osseous changes ( > 0.05).
We found a variable incidence of abnormal radiographic findings on the radial styloid in patients with de Quervain's tenosynovitis and asymptomatic individuals. The presence of sclerosis and osteopenia may be potential risk factors for patients who do not respond to conservative treatment and need surgical intervention.
本研究旨在确定在接受手术或保守治疗的桡骨茎突狭窄性腱鞘炎患者的腕关节后前位X线片上观察到的桡骨茎突骨质变化。
手术治疗组包括24例桡骨茎突狭窄性腱鞘炎患者。保守治疗组和健康对照组各有24名年龄和性别匹配的受试者。我们评估了桡骨茎突骨骺残余处的骨赘形成、骨膜反应、骨质硬化、骨质减少、骨质侵蚀和轮廓隆起情况。比较了这三组异常影像学表现的发生率。还分析了桡骨茎突骨质变化与症状持续时间的相关性。
三组在骨骺残余处的骨膜反应、骨质侵蚀和轮廓隆起方面未发现显著差异。三组在骨赘形成、骨质硬化和骨质减少的发生率上存在显著差异(<0.001)。手术治疗组和保守治疗组的骨赘形成发生率显著高于对照组(<0.001)。手术治疗组和保守治疗组在骨质硬化和骨质减少方面存在显著差异(分别为<0.001,=0.002)。未观察到症状持续时间与桡骨茎突骨质变化之间存在显著关联(>0.05)。
我们发现桡骨茎突狭窄性腱鞘炎患者和无症状个体的桡骨茎突异常影像学表现的发生率各不相同。骨质硬化和骨质减少的存在可能是对保守治疗无反应且需要手术干预的患者的潜在危险因素。