Incidental Signal Changes in the Extensor Carpi Ulnaris on MRI

Kuntz, Michael T.; Janssen, Stein J.; Ring, David

doi:10.1007/s11552-015-9764-9

Cited by 17 publications

(15 citation statements)

References 23 publications

(33 reference statements)

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“…Interestingly, three patients had an operation due to clinical examination on ECU pathology, which was not confirmed on MRI. This is consistent with a large multivariable analysis that revealed that ECU signal changes are common in the absence of clinical diagnosis and that nearly half of patients with a clinical diagnosis had no signal changes [12]. This indicates that MRI is only of limited use in evaluating ECU pathology.…”

Section: Discussionsupporting

confidence: 86%

The clinical significance of magnetic resonance imaging of the hand: an analysis of 318 hand and wrist images referred by hand surgeons

Ratasvuori

Lindfors

Sormaala

2021

Journal of Plastic Surgery and Hand Surgery

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Magnetic resonance imaging (MRI) is a common diagnostic tool in hand surgery. However, there is limited knowledge on the kind of findings that are relevant in treatment planning. We analysed the findings and utility of arm, wrist, metacarpal, and finger MRIs taken in a tertiary hand surgery clinic of 318 consecutive images from 316 patients referred by a hand surgeon or hand surgeon resident. Ganglions (28%), findings on the extensor carpi ulnaris tendon (18%) and on the triangular fibrocartilage (18%) were the most common findings and increased with patient age; the clinical significance of these findings was minimal. The correlation between the clinical scaphoid shift test or the fovea sign test and MRI was also non-significant. Despite findings on MRI, the diagnosis remained unsolved in 76 (24%) cases. However, MRI had a role in reassuring the patient, and in 70% of the cases, further follow-up was unnecessary. This study demonstrates that the indications for wrist and hand MRI must be considered thoroughly and interpretation of the MRI report requires knowledge.

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Section: Discussionsupporting

confidence: 86%

The clinical significance of magnetic resonance imaging of the hand: an analysis of 318 hand and wrist images referred by hand surgeons

Ratasvuori

Lindfors

Sormaala

2021

Journal of Plastic Surgery and Hand Surgery

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“…9,10 Studies on asymptomatic wrists have demonstrated a high rate of incidental TFCC findings, extensor carpi ulnaris pathology, and ganglia. [11][12][13] Multiple conditions, including ligament tears and Preiser disease, could be better imaged with gadolinium-enhanced MR arthrograms rather than routine MR alone. 9,14 MRI can be useful to detect occult carpal bone fractures, but treatment may be unnecessary if they are not visible on CT or radiographs.…”

Section: Discussionmentioning

confidence: 99%

Utility of Specialized Imaging for Diagnosis of Chronic Wrist Pain

et al. 2019

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Background Patients with chronic wrist pain often undergo imaging (such as magnetic resonance imaging [MRI], computed tomography [CT], or ultrasound [US]) prior to specialist assessment. Questions Is specialized wrist imaging performed prior to expert consultation necessary? Are there demographic differences between patients who do or do not receive preconsultation imaging? Patients and Methods A total of 115 patients referred to a tertiary hand center for chronic wrist pain and assessed by a hand surgeon were included. At initial consultation, surgeons were blinded to referral information and previous imaging results. The specialist performed a history, physical examination and reviewed X-rays. They established a clinical diagnosis and whether any additional investigations were needed. Prior MRI, CT, and/or US results were then reviewed and the specialists' clinical diagnosis was compared with the blinded referral diagnosis. Preconsultation imaging was categorized as having no value for diagnosis/management, some value, or high value. Results A total of 82 patients had imaging prior to specialist referral (69 MRIs, 11 CTs, and 16 ultrasounds). The majority of additional imaging (73%) was classified as unnecessary, including 77% of the MRIs and 100% of the ultrasounds. Of all the investigations performed, two CT scans were labeled highly valuable clinical aids. Older patients and those with radial-sided pain were less likely to receive preconsultation imaging. Six patients required further imaging after consultation. Conclusion Clinical assessment and X-rays are typically sufficient for a hand specialist to diagnose and manage chronic wrist pain and few patients require additional imaging. Level of Evidence This is a Level III study.

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“…MRI can be useful for visualization of ECU tendinitis or confirmation of other soft tissue abnormalities such as scapholunate ligament or TFCC tears. 17 Dynamic ultrasound is an effective method for identification of ECU subluxation. 18-20 These differing findings highlight the clinical importance of performing the ECU Synergy Test prior to selecting an imaging modality, in an effort to gain information about injury type and minimize the unnecessary use of imaging studies.…”

Section: Wrist Injuriesmentioning

confidence: 99%

Upper Extremity Injuries in Tennis Players

Chung

Lark

2017

Hand Clinics

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Synopsis Upper extremity tennis injuries are most commonly characterized as overuse injuries to the wrist, elbow and shoulder. The complex anatomy of these structures and their interaction with biomechanical properties of tennis strokes contributes to the diagnostic challenges. A thorough understanding of tennis kinetics, in combination with the current literature surrounding diagnostic and treatment methods, will improve clinical decision-making.

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Incidental Signal Changes in the Extensor Carpi Ulnaris on MRI

Cited by 17 publications

References 23 publications

The clinical significance of magnetic resonance imaging of the hand: an analysis of 318 hand and wrist images referred by hand surgeons

The clinical significance of magnetic resonance imaging of the hand: an analysis of 318 hand and wrist images referred by hand surgeons

Utility of Specialized Imaging for Diagnosis of Chronic Wrist Pain

Upper Extremity Injuries in Tennis Players

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