Clinical Pain

  • 제20권1호
  • /
  • Pages.15-19
  • /
  • 2021
  • /
  • 1598-5490(pISSN)
  • /
  • 2765-5156(eISSN)
대한임상통증학회 (Korean Association of Pain Medicine)
권호 표지
DOI QR코드

DOI QR Code

완관절과 수부 질환의 초음파 소견과 치료

Ultrasound Findings and Treatment of Wrist and Hand Diseases

  • 이종화 (동아대학교 의과대학 재활의학교실)
  • Lee, Jong Hwa (Department of Physical Medicine and Rehabilitation, Dong-A University College of Medicine)
  • 투고 : 2021.06.11
  • 심사 : 2021.06.21
  • 발행 : 2021.06.30
⟨ 이전 논문 다음 논문 ⟩

초록

There are many wrist and hand diseases in which ultrasound can help in the diagnosis and treatment. Because many small structures are located, identifying anatomical locations and pathways is especially important. In De Quervain's syndrome, it is necessary to find tendon lesions located in the first compartment of the wrist. If injection therapy is required, administer the regimen accurately within the tendon sheath through ultrasound. In carpal tunnel syndrome, there are several methods to diagnose a disease by measuring cross-sectional area of the median nerve. Ultrasound has the advantage of administering injection therapy without damaging the nerve. Intersection syndrome can be diagnosed by observing swelling and hypoechoic appearances at the point where the tendons of the first compartment cross over the second compartment of the wrist. Ultrasound-guided injection is also safe and efficient. If there is a trigger finger lesion, the most representative findings is to observe a nodular hypoechoic thickening of the involved A1 pulley. When injection therapy is performed, it is effective to administer medication between pulley and flexor tendons as much as possible to reduce pressure on the attached structures.

키워드

참고문헌

  1. Teh J, Vlychou M. Ultrasound-guided interventional procedures of the wrist and hand. Eur Radiol 2009; 19: 1002-1010 https://doi.org/10.1007/s00330-008-1209-1
  2. Rettig AC. Athletic Injuries of the Wrist and Hand. Am J Sports Med 2004; 32: 262-273 https://doi.org/10.1177/0363546503261422
  3. McDermott J, Ilyas A, Nazarian L, Leinberry C. Ultrasound-guided Injections for de Quervain's Tenosynovitis. Clin Orthop Relat Res 2012; 470: 1925-1931 https://doi.org/10.1007/s11999-012-2369-5
  4. Gordon C, Johnson EW, Gatens PF, Ashton JJ. Wrist ratio correlation with carpal tunnel syndrome in industry. Am J Phys Med Rehabil 1988; 67: 270-272
  5. Duncan I, Sullivan P, Lomas F. Sonography in the diagnosis of carpal tunnel syndrome. Am J Roentgenol 1999; 173: 681-684 https://doi.org/10.2214/ajr.173.3.10470903
  6. Klauser AS, Halpern EJ, De Zordo T, Feuchtner GM, Arora R, Gruber J, et al. Carpal tunnel syndrome assessment with US: value of additional cross-sectional area measurements of the median nerve in patients versus healthy volunteers. Radiology 2009; 250: 171-177 https://doi.org/10.1148/radiol.2501080397
  7. Altinok T, Karakas H. Ultrasonographic evaluation of age-related changes in bowing of the flexor retinaculum. Surg Radiol Anat 2004; 26: 501-503 https://doi.org/10.1007/s00276-004-0268-5
  8. Malone DG, Clark TB, Wei N. Ultrasound-guided percutaneous injection, hydrodissection, and fenestration for carpal tunnel syndrome: description of a new technique. J Appl Res 2011; 10: 107-114
  9. Cooney WP. Sports injuries to the upper extremity. Postgrad Med 1984; 76: 45-50 https://doi.org/10.1080/00325481.1984.11698736
  10. Osterman L, Moskow L, Low CDW. Soft-Tissue Injuries of the Hand and Wrist in Racquet Sports. Clin Sports Med 1988; 7: 329-348 https://doi.org/10.1016/S0278-5919(20)30938-8
  11. Makkouk A, Oetgen M, Swigart C, Dodds S. Trigger finger: etiology, evaluation, and treatment. Curr Rev Musculoskelet Med 2008; 1: 92-96 https://doi.org/10.1007/s12178-007-9012-1
  12. Ryzewicz M, Wolf JM. Trigger Digits: Principles, Management, and Complications. J Hand Surg Am 2006; 31: 135-146 https://doi.org/10.1016/j.jhsa.2005.10.013
  13. Bianchi S, Gitto S, Draghi F. Ultrasound Features of Trigger Finger: Review of the Literature. J Ultrasound Med 2019; 38: 3141-3154 https://doi.org/10.1002/jum.15025
  14. Guerini H, Pessis E, Theumann N, Le Quintrec JS, Campagna R, Chevrot A, et al. Sonographic Appearance of Trigger Fingers. J Ultrasound Med 2008; 27: 1407-1413 https://doi.org/10.7863/jum.2008.27.10.1407
  15. Gitto S, Draghi AG, Draghi F. Sonography of Non-neoplastic Disorders of the Hand and Wrist Tendons. J Ultrasound Med 2018; 37: 51-68 https://doi.org/10.1002/jum.14313
  16. Spirig A, Juon B, Banz Y, Rieben R, Vogelin E. Correlation Between Sonographic and In Vivo Measurement of A1 Pulleys in Trigger Fingers. Ultrasound Med Biol 2016; 42: 1482-1490 https://doi.org/10.1016/j.ultrasmedbio.2016.02.017
  17. Chuang XL, Ooi CC, Chin ST, Png MA, Wong SK, Tay SC, et al. What triggers in trigger finger? The flexor tendons at the flexor digitorum superficialis bifurcation. J Plast Reconstr Aesthet Surg 2017; 70: 1411-1419 https://doi.org/10.1016/j.bjps.2017.05.037
  18. Bodor M, Flossman T. Ultrasound-Guided First Annular Pulley Injection for Trigger Finger. J Ultrasound Med 2009; 28: 737-743 https://doi.org/10.7863/jum.2009.28.6.737