Summary
In the analysis of magnetic resonance (MR) images of the wrist joint, some structural variations may lead to misinterpretation. Our aim was to search for different anatomical variants and their MR characteristics on axial images. Two groups of patients with rheumatoid arthritis (thirty one) and carpal tunnel syndrome (sixty two), and a group of asymptomatic controls (fifty four) underwent bilateral MR axial wrist imaging from the metacarpal bases to the distal radiocarpal joint. The imaging techniques included spin echo (SE), turbo spin echo (TSE) and fast field echo (FFE) sequences, using 3 mm-slice thickness. Different anatomical variants including hypoplasia of the hamulus or hook of the hamate bone (4 cases), anomalous muscles (lumbricals) inside the carpal tunnel (2 cases), unusual location (5 cases) and double branching of the median nerve (14 cases), and aberrant median artery (one case) were detected. These variants, if unfamiliar to MR readers, may be misinterpreted as pathological features.
Résumé
Dans l’analyse des images IRM du poignet, certaines variations anatomiques peuvent conduire à des erreurs d’interprétation. Notre but était de rechercher les caractéristiques IRM des différentes variations anatomiques à partir de coupes axiales. Deux groupes de patients, présentant pour l’un une polyarthrite rhumatoïde (31) et pour l’autre un syndrome du canal carpien (62), et un groupe témoin (54), ont eu un examen IRM des deux poignets dans le plan axial, depuis la base des métacarpiens jusqu’à l’articulation radiocarpienne. LTRM a été réalisée en coupes de 3 mm d’épaisseur en séquence spin echo (SE), turbospin echo (TSE) et en séquence d’imagerie rapide (FFE). Nous avons observé les variations anatomiques suivantes; hypoplasie de l’hamulus (4 cas), muscles lombricaux dans le canal carpien (2 cas), localisation inhabituelle (5 cas) et bifidité (14 cas) du nerf médian, et artère médiane abérante (1 cas). Ces variations, si elles ne sont pas reconnues en IRM, peuvent être interprétées comme des aspects pathologiques.
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Pierre-Jerome, C., Bekkelund, S.I., Husby, G. et al. MRI of anatomical variants of the wrist in women. Surg Radiol Anat 18, 37–41 (1996). https://doi.org/10.1007/BF03207760
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DOI: https://doi.org/10.1007/BF03207760