尺骨撞击综合征的特点及早期诊断

目的探讨尺骨撞击综合征的特点及早期诊断方法并提出新的诊断标准。方法对1998年12月～2004年12月治疗的123例腕尺侧疼痛患者进行仔细检查,采用顾玉东等提出的诊断标准,特别结合腕部MRI检查,确诊尺骨撞击综合征48例。总结尺骨憧击综合征的X线及MRI影像学特点,分析腕部临床症状与Chun和Palmer评分及影像学表现的关系。结果本组33例患者存在尺骨阳性变异(68．8%),X线检查发现患者出现腕骨坏死比例为27．1%,其中以月骨坏死为主(64．7%)；MRI检查均发现腕骨不同程度信号改变,腕部骨坏死均位于月骨尺侧部分的近端和三角骨腰部及底部；患者腕部临床症状与Chun和Palmer评分及影像学表现关系密切。结论提高对尺骨撞击综合征的认识水平,以临床症状为基础,充分利用影像学检查,特别是MRI检查,可以明显提高该病征的早期诊断率。

Early diagnosis of ulnar impaction syndrome

Objective To explore early diagnostic methods for ulnar impaction syndrome on the basis of suggested criteria.Methods From December 1998 to December 2004,123 cases complained of ulnar pain.They were checked and diagnosed according to the criteria of Yu-dong Gu,and especially,the results of wrist MRL Forty-eight of them were diagnosed as ulnar impactinn syndrome.A retrospective study was done to analyze the char- acteristies of X-ray and MRI in examining ulnar impaction syndrome,clinical symptoms of the wrist,and the association between Chun & Palmer's scoring systems and imaging manifestations.Results Most of the cases of ulnar impaction syndrome had positive lunar variance (68.8%).Carpal avascular necrosis was found in about 27.1% of the cases through X-ray examination of the wrist,64.7% of whom were lunar osteonecrosis.Abnormal changes in signal intensity occurred in the MRI findings of the syndrome cases.The carpal necrosis was always located at the ulnar side of lunare or (and) at the waist and bottom of triquetrum.There was a close relationship between clinical symptoms and Chun & Palmer's grading systems and carpal imaging,MRI in particular Conclusion Early diagnosis of ulnar impaction syndrome can be made easily on the basis of deep understanding of the syndrome,clinical symptoms,and findings of imaging,especially MRI.