IMAGING OF THE HAND - DEGENERATION, IMPINGEMENT AND OVERUSE

Degenerative and overuse diseases as well as impingement syndromes of the hand are illustrated and discussed in this review article. Osteoar thritis of the interphalangeal joints as described by Heberden and Bou chard is a ubiquitous articular disease often associated with synoviti s and erosive joint destruction. Osteoarthritis of the trapeziometacar pal joint is classified into four stages for proper indication of oper ation. Overuse can result in stenosing tenosynovitis around the wrist and in synovitis with or without impingement of the flexor or extensor tendons of the digitis or ruptures of the annular and cruciform pulle ys. Although diagnosis of these entities is usually made by history an d clinical investigation, ultrasound and MRI can be helpful tools in i maging of these diseases. Scapholunate advanced collapse (SLAC) and sc aphoid nonunion advanced collapse (SNAC) are the characteristic degene ration pattern of the wrist and represent the degeneration mechanisms in scapholunate insufficiency and nonunion of the scaphoid. SLAG wrist is a gradual degeneration classified in three stages and found in pos ttraumatic scapholunate rupture, calcium pyrophosphate dehydrate depos ition disease (CPPD), rheumatoid arthritis, neuropathic diseases, trau ma, and beta(2)-microglobulin associated amyloid deposition. Ulna impa ction syndrome is increasingly recognized as a cause of ulnar sided pa in and exhibits a characteristic MRI appearance. (C) 1997 Elsevier Sci ence Ireland Ltd.