van Vugt R M, van Dalen A, Bijlsma J W
Department of Rheumatology and Clinical Immunology, University Hospital Utrecht, The Netherlands.
Clin Exp Rheumatol. 1998 Jul-Aug;16(4):454-8.
To assess the current role of ultrasound in the diagnosis and treatment of pathological changes in the wrist and hand.
39 patients (14 male and 25 female, mean age 35 yrs.) with ill-defined pain and/or swelling of the wrist or hand were examined using a high-definition ultrasound (US) instrument.
18 patients had tenosynovitis, which in one patient was due to a previously unsuspected foreign body. 10 patients had arthritis involving the wrist and 5 the fingers; 2 patients had a ganglion; one had a neuroma of the median nerve and one patient with a previous tenorrhaphy suffered from the recurrent rupture of this tendon. Two patients had carpal tunnel syndrome, one due to tenosynovitis and one due to the formation of a post-operative fibrotic sheath around the median nerve. 7 patients with synovitis of the wrist underwent US-guided synovial biopsy. 12 patients with tenosynovitis and 6 with arthritis received injections of corticosteroids plus anaesthetic under US-guidance. The spreading of the steroid crystals around the tendon and throughout the joint could be easily monitored. No complications were encountered.
High-definition ultrasound is a valuable technique for the imaging of pathologic changes of the wrist and hand and for injection therapy.
评估超声在腕关节和手部病理改变诊断及治疗中的当前作用。
使用高清超声仪器对39例腕关节或手部疼痛和/或肿胀不明确的患者（14例男性，25例女性，平均年龄35岁）进行检查。
18例患者患有腱鞘炎，其中1例是由先前未怀疑的异物引起。10例患者患有累及腕关节的关节炎，5例累及手指；2例患者患有腱鞘囊肿；1例患有正中神经神经瘤，1例曾行肌腱缝合术的患者肌腱复发断裂。2例患者患有腕管综合征，1例由腱鞘炎引起，1例由正中神经周围术后纤维化鞘形成引起。7例腕关节滑膜炎患者接受了超声引导下的滑膜活检。12例腱鞘炎患者和6例关节炎患者在超声引导下接受了皮质类固醇加麻醉剂注射。可以很容易地监测类固醇晶体在肌腱周围和整个关节内的扩散情况。未出现并发症。
高清超声是用于腕关节和手部病理改变成像及注射治疗的一种有价值的技术。
