Zhang Miaoru, Yip Stefanie W Y, Wu Su, Yeung David K W, Griffith James F
Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, SAR, China.
Skeletal Radiol. 2025 Jul;54(7):1407-1415. doi: 10.1007/s00256-024-04842-w. Epub 2024 Dec 4.
To study the effect of direct wrist traction on patient pain and joint distraction on MRI.
291 patients (109 males, 182 females; mean age, 45.8 years) who underwent wrist MRI between November 2019 and September 2024 were studied (152 patients with traction, 139 patients without traction). All patients completed a questionnaire assessing wrist pain scores before, during, and ten minutes after MRI examination. Joint space width and cartilage visibility of the radiocarpal and intercarpal joints were assessed. For patients with arthroscopy within one year after MRI, diagnostic accuracy of intrinsic ligament and triangular fibrocartilage complex tears was assessed.
Fifty-seven (38%) of 152 traction patients had an average increase of 1 point (range, 0 ~ 2) in wrist pain following traction compared to 24 (17%) of 139 non-traction patients (p = 0.085). 44% traction patients and 38% non-traction patients reported non-wrist pain (mainly shoulder, neck), with no inter-group difference in location, prevalence, or pain score (all p values > 0.05). Average joint space width was 0.6 mm wider in the traction group (p < 0.001). On average, eighty-five (60%) of 141 traction patients had 'moderate' or 'good' articular cartilage visibility compared to 22 (17%) of 126 non-traction patients (p < 0.001). Traction tended to increase diagnostic accuracy for intrinsic ligament tear, though it did not reach statistical significance (p = 0.136).
Compared to wrist MRI without traction, traction increases joint space width and improves cartilage visibility, though with a slight increase in wrist pain.
研究直接腕部牵引对患者疼痛的影响以及MRI上关节间隙增宽情况。
对2019年11月至2024年9月期间接受腕部MRI检查的291例患者（109例男性，182例女性；平均年龄45.8岁）进行研究（152例接受牵引，139例未接受牵引）。所有患者均完成了一份问卷，评估MRI检查前、检查期间及检查后十分钟的腕部疼痛评分。评估桡腕关节和腕骨间关节的关节间隙宽度及软骨可视性。对于MRI检查后一年内接受关节镜检查的患者，评估内在韧带和三角纤维软骨复合体撕裂的诊断准确性。
152例接受牵引的患者中有57例（38%）在牵引后腕部疼痛平均增加1分（范围0～2分），而139例未接受牵引的患者中有24例（17%）出现这种情况（p = 0.085）。44%接受牵引的患者和38%未接受牵引的患者报告有非腕部疼痛（主要是肩部、颈部），在疼痛部位、发生率或疼痛评分方面两组间无差异（所有p值>0.05）。牵引组的平均关节间隙宽度宽0.6毫米（p < 0.001）。平均而言，141例接受牵引的患者中有85例（60%）关节软骨可视性为“中等”或“良好”，而126例未接受牵引的患者中有22例（17%）达到这种情况（p < 0.001）。牵引倾向于提高内在韧带撕裂的诊断准确性，尽管未达到统计学意义（p = 0.136）。
与未进行牵引的腕部MRI相比，牵引可增加关节间隙宽度并改善软骨可视性，不过会使腕部疼痛略有增加。
