Sanders W E
J Hand Surg Br. 1985 Jun;10(2):257-60. doi: 10.1016/0266-7681(85)90034-8.
Chronic wrist pain has many causes, the diagnosis of which is often difficult. Clinical and anatomical research in this area has replaced the diagnosis of "wrist sprain" with a differential diagnosis including carpal chondromalacia, dynamic carpal instability, positive and negative ulnar variance, triangular fibrocartilage complex injuries, and early carpal avascular necrosis. The ubiquitous dorsal ganglion can also cause chronic wrist discomfort and the diagnosis of "occult dorsal carpal ganglion" should be included in the differential diagnosis. Nine patients with chronic wrist pain were diagnosed clinically as having an occult dorsal carpal ganglion despite the absence of a palpable mass. Each was treated by limited dorsal capsulectomy with excision of a small portion of the dorsal scapho-lunate ligament, and small intracapsular ganglia and/or cystic mucinous degeneration of the capsule were found in all nine patients. Of the eight patients available for follow-up examination, the preoperative pain was relieved in seven of the eight and no recurrences were noted at follow-up averaging six months.
慢性腕关节疼痛病因众多，其诊断往往困难。该领域的临床与解剖学研究已将“腕关节扭伤”的诊断替换为鉴别诊断，包括腕骨软骨软化症、动态腕关节不稳、正性和负性尺骨变异、三角纤维软骨复合体损伤以及早期腕骨缺血性坏死。常见的背侧腱鞘囊肿也可导致慢性腕关节不适，鉴别诊断应包括“隐匿性背侧腕关节腱鞘囊肿”。9例慢性腕关节疼痛患者临床诊断为隐匿性背侧腕关节腱鞘囊肿，尽管未触及肿块。所有患者均接受了有限的背侧关节囊切除术，切除一小部分背侧舟月韧带，且在所有9例患者中均发现了小的关节内腱鞘囊肿和/或关节囊的囊性黏液样变性。在可供随访检查的8例患者中，8例中有7例术前疼痛得到缓解，随访平均6个月时未见复发。
