Imaging of Athletic Wrist and Hand Injuries

Joel L. Rosner; Michael B. Zlatkin; Paul Clifford; Elizabeth A. Ouellette; Mark H. Awh

doi:10.1055/s-2004-823015

Seminars in Musculoskeletal Radiology, Table of Contents

Semin Musculoskelet Radiol 2004; 8(1): 57-79
DOI: 10.1055/s-2004-823015

Imaging of Athletic Wrist and Hand Injuries

Joel L. Rosner¹ ^, ² , Michael B. Zlatkin¹ ^, ² , Paul Clifford² , Elizabeth A. Ouellette³ ^, ⁴ , Mark H. Awh⁵

¹National Musculoskeletal Imaging, Inc., Miami, FL
²Department of Radiology, University of Miami, Miami, FL
³Division of Hand Surgery, Department of Orthopaedics and Rehabilitation, University of Miami, Miami, FL
⁴Anne Bates Leach Eye Hospital, Miami, FL
⁵Radsource, LLC, Brentwood, TN

Abstract

Sports-related injuries of the wrist and hand are commonly encountered in clinical practice. Athletic injuries create special challenges for the orthopedic surgeon and radiologist, as these patients expect to recover quickly and return to the same athletic endeavors that caused their original injuries. A thorough understanding of the mechanism of injury and imaging findings are necessary for accurate diagnosis and effective therapy. This knowledge allows the clinician to effectively educate the athlete concerning the risks, complications, and prognosis of the injury and its treatment. This article will review mechanisms of injury, imaging findings, and some therapeutic options of common sports-related injuries to the wrist and hand.

KEYWORDS

Athlete - imaging - wrist - hand - trauma

Full Text

References

REFERENCES

1 Rettig A C. Epidemiology of hand and wrist injuries in sports. Clin Sports Med. 1998; 17 401-406
2 Geissler W. Carpal fracture in athletes. Clinics in Sports Medicine. Clin Sports Med. 2001; 20 167-188
3 Steinberg B. Acute wrist injuries in the athlete. Orthop Clin North Am. 2002; 33 535-545
4 Luckstead E, Satran A, Patel D. Sports injury profiles, training and rehabilitation issues in American sports. Pediatr Clin North Am. 2002; 49 753-767
5 Schreibman K, Freeland A, Gilula L, Yin Y. Imaging of the hand and wrist. Orthop Clin North Am. 1997; 28 537-582
6 Rettig M, Dassa G, Raskin K, Melone C. Wrist fractures in the athlete: distal radius and carpal fractures. Clin Sports Med. 1998; 17 469-489
7 Ritchie J V, Munter D W. Emergency department evaluation and treatment of wrist injuries. Emerg Med Clin North Am. 1999; 17 823-842
8 Breitenseher M J, Metz V M, Gilula L A et al.. Radiographically occult scaphoid fractures: value of MR imaging in detection. Radiology. 1997; 203 245-250
9 Peh W, Gilula L, Wilson A. Detection of occult wrist fractures by magnetic resonance imaging. Clin Radiol. 1996; 51 285-292
10 Schmitt R, Heinze A, Fellner F, Obletter N, Struhn R, Bautz W. Imaging and staging of avascular osteonecrosis at the wrist and hand. Eur J Radiol. 1997; 25 92-103
11 Weinberg E P, Hollenberg G M, Adams M J, Tan R K, Lechner M J. High-resolution outpatient imaging of the wrist. Semin Musculoskelet Radiol. 2001; 5 227-234
12 Perlik P C, Guilford W B. Magnetic resonance imaging to assess vascularity of scaphoid nonunions. J Hand Surg [Am]. 1991; 16A 479-484
13 Brody G A, Stoller D W. CH. 8 The wrist and hand. In: Stoller DW Magnetic Resonance Imaging in Orthopedics and Sports M. Philadelphia; JB Lippincott 1993: 683-807
14 Resnik C. Wrist and hand injuries. Seminars Musculoskelet Radiol. 2000; 4 193-204
15 Bishop A, Beckenbaugh R. Fracture of the hamate hook. J Hand Surg [Am]. 1988; 13 135-139
16 Hanel D P, Jones M D, Trumble T E. Wrist fractures. Orthop Clin North Am. 2002; 33 35-57
17 Nguyen D, McCue F C, Urch S E. Evaluation of the injured wrist on the field and in the office. Clin Sports Med. 1998; 17 421-432
18 Trumble T, Schmitt S, Vedder N. Factors affecting functional outcome of displaced intra-articular distal radial fractures. J. Hand Surg [Am]. 1994; 19 325-329
19 Cole R, Bindra R R, Evanoff B A et al.. Radiographic evaluation of osseous displacement following intra-articular fractures of the distal radius: reliability of plain radiography versus computer tomography. J Hand Surg [Am]. 1997; 22 792-800
20 Yaghoubian R, Goebel F, Musgrave D, Sotereanos D. Diagnosis and management of acute fracture-dislocation of the carpus. Orthop Clin North Am. 2001; 32 295-305
21 Mayfield J, Johnson R, Kilcoyne R. Carpal dislocations: pathomechanics and progressive perilunate instability. J Hand Surg [Am]. 1980; 5 226-241
22 Oneson S, Scales L, Timins M, Erickson S, Chamoy L. MR imaging interpretation of Palmer classification of triangular fibrocartilage complex lesions. Radiographics. 1996; 16 97-106
23 Cober S R, Trumble T E. Arthroscopic repair of triangular fibrocartilage complex injuries. Orthop Clin North Am. 2001; 32 279-294
24 Sofka C M, Potter H G. Magnetic resonance imaging of the wrist. Semin Musculoskelet Radiol. 2001; 5 217-226
25 Palmer A K. Triangular fibrocartilage complex lesions: a classification. J Hand Surg [Am]. 1989; 14 594-605
26 Zanetti M, Linkous M D, Gilula L A, Hodler J. Characteristics of triangular fibrocartilage defects in symptomatic and contralateral asymptomatic wrist. Radiology. 2000; 216 840-845
27 Zlatkin M B, Chao P C, Osterman A L et al.. Chronic wrist pain: evaluation with high-resolution MR imaging. Radiology. 1989; 173 723-729
28 Potter H G, Asnis-Ernberg L, Weiland A J, Hotchkiss R N, Peterson M G, McCormack Jr R R. The utility of high-resolution magnetic resonance imaging in the evaluation of the triangular fibrocartilage complex of the wrist. J Bone Joint Surg Am. 1997; 79 1675-1684
29 Haims A H, Schweitzer M E, Morrison W B et al.. Limitations of MR Imaging in the diagnosis of peripheral tears of the triangular fibrocartilage of the wrist. AJR Am J Roentgenol. 2002; 178 419-422
30 Nagle D J. Triangular fibrocartilage complex tears in the athlete. Clin Sports Med. 2001; 20 155-166
31 Adams B D, Divelbiss B J. Reconstruction of the posttraumatic unstable distal radioulnar joint. Orthop Clin North Am. 2001; 32 353-363
32 Mino D E, Palmer A K, Levinsohn E M. Radiography and computerized tomography in the diagnosis of incongruity of the distal radioulnar joint. J Bone Joint Surg Am. 1985; 67 247-252
33 Staron R B, Feldman F, Haramati N, Singson R D, Rosenwasser M, Esser P D. Abnormal geometry of the distal radioulnar joint: MR findings. Skeletal Radiol. 1994; 23 369-372
34 Lewis D M, Osterman A L. Scapholunate instability in athletes. Clin Sports Med. 2001; 20 131-140
35 Timins M, Jahnke J, Krah S, Erickson S, Carrera G. MR imaging of the major carpal stabilizing ligaments: normal anatomy and clinical examples. Radiographics. 1995; 15 575-587
36 Scheck R J, Kubitzek C, Hierner R et al.. The scapholunate interosseous ligament in MR arthrography of the wrist: correlation with non-enhanced MRI and wrist arthroscopy. Skeletal Radiol. 1997; 26 263-271
37 Linkous M D, Pierce S D, Gilula L A. Scapholunate ligamentous communicating defects in symptomatic and asymptomatic wrists: characteristics. Radiology. 2000; 216 846-850
38 Smith D K. MR imaging of normal and injured wrist ligaments. Magn Reson Imaging Clin N Am. 1995; 3 229-248
39 El-Noueam K I, Schweitzer M E, Blasbaig R et al.. Is a subset of wrist ganglia the sequela of internal derangements of the wrist joint? MR imaging findings. Radiology. 1999; 212 537-540
40 Schofield B A, Ouelette E A, Zlatkin M B, Murphy B. MRI correlation with scapholunate ligament tears. , Presented at the annual meeting of the American Academy of Orthopedic Surgeons. Orlando, FL, February 1995;
41 Anderson M W, Kaplan P A, Dussault R G, Degnan G G. Magnetic resonance imaging of the wrist. Curr Probl Diagn Radiol. 1998; 27 187-229
42 Oneson S R, Scales L M, Erickson S T, Timins M E. MR imaging of the painful wrist. Radiographics. 1996; 16 997-1008
43 Clavero J A, Alomar X, Monill J M et al.. MR imaging of ligament and tendon injuries of the fingers. Radiographics. 2002; 22 237-256
44 Perron A D, Brady W J, Keats T E, Hersh R E. Orthopedic pitfalls in the emergency department: closed tendon injuries of the hand. Am J Emerg Med. 2001; 19 76-80
45 Lee S J, Montgomery K. Athletic hand injuries. Orthop Clin North Am. 2002; 33 547-554
46 Palmer R E. Joint injuries of the hand in athletes. Clin Sports Med. 1998; 17 513-531
47 Hinke D H, Erickson S J, Chamoy L, Timins M E. Ulnar collateral ligament of the thumb: MR findings in cadavers, volunteers, and patients with ligamentous injury (gamekeeper's thumb). AJR Am J Roentgenol. 1994; 163 1431-1434
48 Langford S, Whitaker J, Toby E. Thumb injuries in the athletes. Clin Sports Med. 1998; 17 553-566
49 Capo J, Hastings II H. Metacarpal and phalangeal fractures in athletes. Clin Sports Med. 1998; 17 491-511
50 Hauger O, Chung C B, Lektrakul N et al.. Pulley system in the fingers: normal anatomy and simulated lesions in cadavers at MR imaging, CT, and US with and without contrast material distention of the tendon sheath. Radiology. 2000; 217 201-212
51 Klausser A, Bodner G, Fraushcer F, Gabl M, Zur Nedden D. Finger injuries in extreme rock climbers: assessment of high-resolution ultrasonography. Am J Sports Med. 1999; 27 733-777
52 Peterson W W, Manske P R, Bollinger B A, Lesker P A, McCarthy J A. Effect of pulley excision flexor tendon biomechanics. J Orthop Res. 1986; 4 96-101
53 Rettig A. Wrist and hand overuse syndromes. Clin Sports Med. 2001; 20 591-611
54 Glajchen N, Schweitzer M. MRI features in de Quervain's tenosynovitis of the wrist. Skeletal Radiol. 1996; 25 63-65
55 Winterer J T, Ghanem N, Roth M et al.. Diagnosis of the hypothenar hammer syndrome by high-resolution contrast-enhanced MR angiography. Eur Radiol. 2002; 12 2457-2462
56 Mueller L P, Mueller L A, Degreif J, Rommens P M. Hypothenar hammer syndrome in a golf player: a case report. Am J Sports Med. 2000; 28 741-745
57 Kransdorf M J, Turner-Stepahin S, Merritt W H. Magnetic resonance angiography of the hand and wrist: evaluation of patients with severe ischemic disease. J Reconstr Microsurg. 1998; 14 77-81

Joel L RosnerM.D.

13798 Northwest 4th Street, Suite 305

Sunrise, FL 33325

Email: jrosner@nationalrad.com