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MR imaging of ulnar impaction

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Abstract

The ulnar impaction syndrome of the wrist is a well-recognized clinical entity, usually showing distinct radiographic features including a positive ulnar variance and degenerative subchondral changes of the distal ulna, proximal lunate, and proximal triquetrum. Confirmation of the clinical and plain film findings with advanced imaging is often necessary to exclude other entities with a similar clinical presentation. Although arthrography and bone scintigraphy are helpful in this work-up, magnetic resonance imaging (MRI) appears to be both a sensitive and a specific means of evaluation. The imaging studies in four patients with clinically and surgically diagnosed ulnar impaction are described, with emphasis on MRI findings. MRI appears to be the modality of choice in the evaluation of patients with suspected ulnolunate impingement.

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References

  1. Milch H. Cuff resection of the ulna for malunited Colles' fracture. J Bone Joint Surg 1941; 23: 311–313.

    Google Scholar 

  2. Palmer A, Werner F. Biomechanics of the distal radioulnar joint. Clin Orthop 1984; 187: 26–35.

    Google Scholar 

  3. Palmer A. Triangular fibrocartilage lesions: a classification. J Hand Surg [Am] 1989; 14A: 594–606.

    Google Scholar 

  4. Chun S, Palmer AK. The ulnar impaction syndrome: followup of ulnar shortening osteotomy. J Hand Surg [Am] 1993; 18:46–53.

    Google Scholar 

  5. Friedman SL, Palmer AK. The ulnar impaction syndrome. Hand Clin 1991; 7: 295–310.

    Google Scholar 

  6. Tolat AR, Sanderson PL, De SL, Stanley JK. The gymnast's wrist: acquired positive ulnar variance following chronic epiphyseal injury. J Hand Surg [Br] 17: 678–681.

  7. Trumble TE, Easterling KJ, Smith RJ. Ulnocarpal abutment after wrist arthrodesis. J Hand Surg [AM] 1988; 13: 11–15.

    Google Scholar 

  8. Mikic Z. Age changes in the triangular fibrocartilage of the wrist joint. J Anat 1978; 126: 367–384.

    Google Scholar 

  9. Palmer AK, Werner FW. The triangular fibrocartilage complex of the wrist — anatomy and function. J Hand Surg [Am] 1981; 6: 153–162.

    Google Scholar 

  10. Viegas S, Ballantyne G. Attritional lesions of the wrist joint. J Hand Surg [Am] 1987; 12A: 1025–1029.

    Google Scholar 

  11. North E, Meyer S. Wrist injuries: correlation of clinical and arthroscopic findings. J Hand Surg [Am] 1990; 15A: 915–920.

    Google Scholar 

  12. Reinus W, Hardy D, Totty W. Arthrographic evaluation of the carpal triangular fibrocartilage complex. J Hand Surg [Am] 1987; 12A: 495–503.

    Google Scholar 

  13. Szabo R, Greenspan A. Diagnosis and clinical findings of Kienbock's disease. Hand Clin 1993; 9: 399–407.

    Google Scholar 

  14. Dalinka M, Meyer S, Kricun M, Vanel D. Magnetic resonance imaging of the wrist. Hand Clin 1991; 7: 87–98.

    Google Scholar 

  15. Golimbu C, Firooznia H, Melone C, Rafii M, Weinreb H, Leber C. Tears of the triangular fibrocartilage of the wrist: MR imaging. Radiology 1989; 173: 731–733.

    Google Scholar 

  16. Gundry C, Kursunoglu-Brahme S, Scweigopher B, Kang H, Sartoris D, Resnick D. Is MR better than arthrography for evaluating ligaments of the wrist? AJR 1990; 154: 337–341.

    Google Scholar 

  17. Schweitzer M, Brahme S, Hodler J. Chronic wrist pain: spin echo and short tau inversion recovery MR imaging and conventional MR arthrography. Radiology 1992; 182: 205–211.

    Google Scholar 

  18. Zlatkin M, Chao P, Osterman A, Schnall M, Dalinka M, Kressel H. Chronic wrist pain — evaluation with high resolution MR imaging. Radiology 1989; 173: 723–729.

    Google Scholar 

  19. Kang H, Kindynis P, Brahme S. Triangular fibrocartilage and intercarpal ligaments of the wrist: MR imaging. Radiology 1991; 181:401–404.

    Google Scholar 

  20. Reicher M, Kellerhouse L. MRI of the wrist and hand. New York: Raven Press, 1990.

    Google Scholar 

  21. Stoller D. Magnetic resonance imaging in orthopedics and sports medicine. Philadelphia: Lippincott, 1993.

    Google Scholar 

  22. Gelberman R, Salamon P, Jurist J, Posch J. Ulnar variance in Kienböck's disease. J Bone Joint Surg [Am] 1975; 57A: 674–676.

    Google Scholar 

  23. Hulten O. Über anatomische Variationen der Hand-Gelenkknochen. Acta Radiol 1928; 9: 155–169.

    Google Scholar 

  24. Mirabello S, Rosenthal D, Smith R. Correlation of clinical and radiographic findings in Kienböck's disease. J Hand Surg [Am] 1987; 12A: 1049–1054.

    Google Scholar 

  25. Reinus W, Conway W, Totty W. Carpal avascular necrosis. Radiology 1986; 170: 689–693.

    Google Scholar 

  26. Sowa D, Holder L, Patt P, Weiland A. Application of magnetic resonance imaging to ischemic necrosis of the lunate. J Hand Surg [Am] 1989; 14A: 1008–1016.

    Google Scholar 

  27. Boulas HJ, Milek MA. Ulnar shortening for tears of the triangular fibrocartilaginous complex. J Hand Surg [Am] 1990; 15: 415–420.

    Google Scholar 

  28. Bowers WH. Distal radioulnar joint arthroplasty: the hemiresection-interposition technique. J Hand Surg [Am] 1985; 10: 169–178.

    Google Scholar 

  29. Dingman P. Resection of the distal end of the ulna (Darrach operation). J Bone Joint Surg [Am] 1952; 34A: 893–900.

    Google Scholar 

  30. Feldon P, Terrono AL, Belsky MR. Wafer distal ulna resection for triangular fibrocartilage tears and/or ulna impaction syndrome. J Hand Surg [Am] 1992; 17: 731–737.

    Google Scholar 

  31. Darrow JCJ, Linscheid RL, Dobyns JH, Mann JM, Wood MB, Beckenbaugh RD. Distal ulnar recession for disorders of the distal radioulnar joint. J Hand Surg [Am] 1985; 10: 482–491.

    Google Scholar 

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Escobedo, E.M., Bergman, A.G. & Hunter, J.C. MR imaging of ulnar impaction. Skeletal Radiol. 24, 85–90 (1995). https://doi.org/10.1007/BF00198066

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