THE CURRENT ROLE OF HIGH-RESOLUTION ULTRASONOGRAPHY OF THE HAND AND WRIST IN RHEUMATIC DISEASES

Objective To assess the current role of ultrasound in the diagnosis an d treatment of pathological changes in the wrist and hand. Methods 39 patients (14 male and 25 female, mean age 35 yrs.) with ill-defined pa in and/or swelling of the wrist or hand were examined using a high-def inition ultrasound (US) instrument Results 18 patients had tenosynovit is, which in one patient was due to a previously unsuspected foreign b ody. 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 o ne patient with a previous tenorrhaphy suffered from the recurrent rap ture of this tendon. Two patients had carpal tunnel syndrome, one due to tenosynovitis and one due to the formation of a post-operative fibr otic sheath around the median nerve. 7 patients with synovitis of the wrist underwent US-guided synovial biopsy. 12 patients with tenosynovi tis and 6 with arthritis received injections of corticosteroids plus a naesthetic under US-guidance The spreading of the steroid crystals aro und the tendon and throughout the joint could be easily monitored. No complications were encountered. Conclusion High-definition ultrasound is a valuable technique for the imaging of pathologic changes of the w rist and hand and for injection therapy.