Roentgenographic Diagnosis of the Painful Wrist

Gilula, Louis A.; Destouet, J M; Weeks, Paul M.; Young, Leroy V.; WRAY, R. CHRIS

doi:10.1097/00003086-198407000-00008

Cited by 83 publications

(21 citation statements)

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“…Co-existence of other inflammatory disorders have been reported in association with injury to the SBR [2,12,18,19], as seen in five patients of our series. In some instances, it is suggested that "inflammation of the sensory nerve occurs secondarily to the diseased tenosynovial structures" [19] and, hence, one must recognize that the patient has superficial radial neuritis before surgery or other modalities of treatment are employed.…”

Section: Discussionsupporting

confidence: 70%

Cheiralgia paresthetica ? entrapment of the superficial branch of the radial nerve: a report of 15 cases

Stahl

Kaufman

1997

Eur J Plast Surg

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Abstract. Attention is drawn to the relatively rare and poorly appreciated clinical featues of entrapment of the superficial sensory branch of the radial nerve (SBR) in the forearm. In a series of 15 patients with cheiralgia paresthetica, alleviation of pain and discomfort was achieved in 66.6% of the conservatively-treated patients and in 80% of the five non-responsive patients who required neurolysis of the nerve. Job-related symptoms were exhibited by 33.3% of the patients, which subsided upon job modification or less hand-intensive work and conservative treatment. We suggest that modalities of treatment should be appropriate for the pathophysioloy of the SBR injury, while early recognition of the syndrome reduces the necessity for surgery.

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Section: Discussionsupporting

confidence: 70%

Cheiralgia paresthetica ? entrapment of the superficial branch of the radial nerve: a report of 15 cases

Stahl

Kaufman

1997

Eur J Plast Surg

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“…5,9,10 Despite the severe disruption of carpal anatomy, diagnosis can be surprisingly difficult and missed frequently. [11][12][13] The findings can be subtle on routinely done posteroanterior and lateral plain radiographs. Traction views may help to define the pattern of injury.…”

Section: Discussionmentioning

confidence: 99%

“…The key to diagnosis is recognizing the disruption of the radius-lunate-capitate axis. 12,13 Dislocation of the capitate head from the concavity of the distal lunate is the defining feature. 13 Most of the patients presented late in our study had taken initial treatment from local untrained practitioner.…”

Section: Discussionmentioning

confidence: 99%

Functional outcome after surgical treatment of perilunate injuries: A series of 12 cases

Gupta

Kamboj

2016

Journal of Clinical Orthopaedics and Trauma

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“…10 Uneven spacing or overlapping of the carpal bones and disruption of Gilula's lines suggests a ligamentous injury that may be associated with a perilunate dislocation ( fig 5⇓). Additionally, the lunate may appear triangular on posteroanterior films owing to its angulation and displacement.…”

Section: Investigationsmentioning

confidence: 99%

Perilunate dislocation

Navaratnam

Ball

Emerson

et al. 2012

BMJ

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This is one of a series of occasional articles highlighting conditions that may be more common than many doctors realise or may be missed at first presentation. The series advisers are Anthony Harnden, university lecturer in general practice, Department of Primary Health Care, University of Oxford, and Richard Lehman, general practitioner, Banbury. To suggest a topic for this series, please email us at easilymissed@bmj.comA 30 year old, right hand dominant mechanic presented to the emergency department with a swollen, painful right wrist after he fell on to an outstretched right hand from a motorcycle travelling at high speed. Radiographs were interpreted as normal and the patient was discharged with a diagnosis of a wrist sprain. The next morning he presented again to the same emergency department with a new symptom: numbness of the right thumb and index, middle, and ring fingers. The radiographs were reviewed and a perilunate dislocation with median nerve compression was diagnosed. That afternoon the patient had median nerve decompression and open reduction and stabilisation of the perilunate dislocation with ligament repair. PRACTICE Key points• Remain vigilant about the possibility of perilunate dislocation in patients who sustain high energy hyperextension wrist injuries with or without carpal bone fractures• Delay in diagnosis can result in injury to the median nerve in the acute setting and post-traumatic arthritis• Confirm the diagnosis with posteroanterior and lateral plain wrist radiography, which would show the "spilled teacup" sign (lunate angulated volarly) and disruption of the smooth borders of the carpal rows (Gilula's lines)• Immediate management involves closed reduction, followed by early surgical repair (stabilisation and fixation)

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Roentgenographic Diagnosis of the Painful Wrist

Cited by 83 publications

References 0 publications

Cheiralgia paresthetica ? entrapment of the superficial branch of the radial nerve: a report of 15 cases

Cheiralgia paresthetica ? entrapment of the superficial branch of the radial nerve: a report of 15 cases

Functional outcome after surgical treatment of perilunate injuries: A series of 12 cases

Perilunate dislocation

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