Skip to main content
SpringerLink
Log in

Athletic injuries of the extensor carpi ulnaris subsheath: MRI findings and utility of gadolinium-enhanced fat-saturated T1-weighted sequences with wrist pronation and supination

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objective

To report the magnetic resonance imaging (MRI) findings in athletic injuries of the extensor carpi ulnaris (ECU) subsheath, assessing the utility of gadolinium-enhanced (Gd) fat-saturated (FS) T1-weighted sequences with wrist pronation and supination.

Methods

Sixteen patients (13 male, three female; mean age 30.3 years) with athletic injuries of the ECU subsheath sustained between January 2003 and June 2009 were included in this retrospective study. Initial and follow-up 1.5-T wrist MRIs were performed with transverse T1-weighted and STIR sequences in pronation, and Gd FS T1-weighted sequences with wrist pronation and supination. Two radiologists assessed the type of injury (A to C), ECU tendon stability, associated lesions and rated pulse sequences using a three-point scale: 1 = poor, 2 = good and 3 = excellent.

Results

Gd-enhanced FS T1-weighted transverse sequences in supination (2.63) and pronation (2.56) were most valuable, compared with STIR (2.19) and T1-weighted (1.94). Nine type A, one type B and six type C injuries were found. There were trends towards diminution in size, signal intensity and enhancement of associated pouches on follow-up MRI and tendon stabilisation within the ulnar groove.

Conclusion

Gd-enhanced FS T1-weighted sequences with wrist pronation and supination are most valuable in assessing and follow-up athletic injuries of the ECU subsheath on 1.5-T MRI.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Spinner M, Kaplan EB (1970) Extensor carpi ulnaris. Its relationship to the stability of the distal radio-ulnar joint. Clin Orthop Relat Res 68:124–129

    Article  CAS  PubMed  Google Scholar 

  2. Taleisnik J, Gelberman RH, Miller BW, Szabo RM (1984) The extensor retinaculum of the wrist. J Hand Surg Am 9:495–501

    CAS  PubMed  Google Scholar 

  3. Montalvan B, Parier J, Brasseur JL, Le Viet D, Drape JL (2006) Extensor carpi ulnaris injuries in tennis players: a study of 28 cases. Br J Sports Med 40:424–429

    Article  CAS  PubMed  Google Scholar 

  4. Burkhart SS, Wood MB, Linscheid RL (1982) Posttraumatic recurrent subluxation of the extensor carpi ulnaris tendon. J Hand Surg Am 7:1–3

    CAS  PubMed  Google Scholar 

  5. Cone RO, Szabo R, Resnick D, Gelberman R, Taleisnik J, Gilula LA (1983) Computed tomography of the normal soft tissues of the wrist. Invest Radiol 18:546–551

    Article  CAS  PubMed  Google Scholar 

  6. Pfirrmann CW, Theumann NH, Chung CB, Botte MJ, Trudell DJ, Resnick D (2001) What happens to the triangular fibrocartilage complex during pronation and supination of the forearm? Analysis of its morphology and diagnostic assessment with MR arthrography. Skeletal Radiol 30:677–685

    Article  CAS  PubMed  Google Scholar 

  7. Elder G, Harvey AJ (2005) Hand and wrist tendinopathies. In: Maffulli N, Renström P, Wayne B (eds) Tendon injuries: basic science and clinical medicine, 3rd edn. Springer, London, pp 137–149

    Google Scholar 

  8. Rettig AC (2004) Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med 32:262–273

    Article  PubMed  Google Scholar 

  9. Inoue G, Tamura Y (2001) Surgical treatment for recurrent dislocation of the extensor carpi ulnaris tendon. J Hand Surg Br 26:556–559

    CAS  PubMed  Google Scholar 

  10. Pratt RK, Hoy GA, Bass Franzcr C (2004) Extensor carpi ulnaris subluxation or dislocation? Ultrasound measurement of tendon excursion and normal values. Hand Surg 9:137–143

    Article  CAS  PubMed  Google Scholar 

  11. MacLennan AJ, Nemechek NM, Waitayawinyu T, Trumble TE (2008) Diagnosis and anatomic reconstruction of extensor carpi ulnaris subluxation. J Hand Surg Am 33:59–64

    Article  PubMed  Google Scholar 

  12. Lee KS, Ablove RH, Singh S, De Smet AA, Haaland B, Fine JP (2009) Ultrasound imaging of normal displacement of the extensor carpi ulnaris tendon within the ulnar groove in 12 forearm-wrist positions. AJR Am J Roentgenol 193:651–655

    Article  PubMed  Google Scholar 

  13. Rayan GM (1983) Recurrent dislocation of the extensor carpi ulnaris in athletes. Am J Sports Med 11:183–184

    Article  CAS  PubMed  Google Scholar 

  14. Beckenbaugh RD (1987) Acute traumatic subluxation. J Hand Surg Am 12:810–811

    CAS  PubMed  Google Scholar 

  15. Rowland SA (1986) Acute traumatic subluxation of the extensor carpi ulnaris tendon at the wrist. J Hand Surg Am 11:809–811

    CAS  PubMed  Google Scholar 

  16. Allende C, Le Viet D (2005) Extensor carpi ulnaris problems at the wrist—classification, surgical treatment and results. J Hand Surg Br 30:265–272

    Article  CAS  PubMed  Google Scholar 

  17. Eckhardt WA, Palmer AK (1981) Recurrent dislocation of extensor carpi ulnaris tendon. J Hand Surg Am 6:629–631

    CAS  PubMed  Google Scholar 

  18. Cohen J (1968) Weighted kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull 70:213–220

    Article  CAS  PubMed  Google Scholar 

  19. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We gratefully thank Oren Semoun for assistance with his statistical analysis and Jérémie Uldry for his computer graphics work.

Author information

Authors and Affiliations

  1. Department of Radiology B, Hôpital Cochin, AP-HP, Université Paris Descartes, Rue du Faubourg Saint-Jacques 27, 75014, Paris, France

    Jeremy Jeantroux, Fabio Becce, Henri Guerini & Jean-Luc Drapé

  2. Department of Diagnostic and Interventional Radiology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, 1011, Lausanne, Switzerland

    Fabio Becce

  3. French Tennis Federation, 75016, Paris, France

    Bernard Montalvan

  4. Hand Institute, Clinique Jouvenet, 75016, Paris, France

    Dominique Le Viet

Authors
  1. Jeremy Jeantroux
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fabio Becce
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Henri Guerini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bernard Montalvan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dominique Le Viet
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jean-Luc Drapé
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-Luc Drapé.

Additional information

J. Jeantroux and F. Becce contributed equally to this work

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jeantroux, J., Becce, F., Guerini, H. et al. Athletic injuries of the extensor carpi ulnaris subsheath: MRI findings and utility of gadolinium-enhanced fat-saturated T1-weighted sequences with wrist pronation and supination. Eur Radiol 21, 160–166 (2011). https://doi.org/10.1007/s00330-010-1887-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-010-1887-3

Keywords

Search

Navigation