训练致腕部尺骨撞击综合征的诊断

目的探讨训练导致尺骨撞击综合征的诊断方法。方法对2000-03~2006-02接诊的187例训练致腕尺侧疼痛患者按照顾玉东的临床诊断标准进行仔细甄别,特别结合腕部MRI检查,确诊尺骨撞击综合征43例。结果本组患者尺骨阳性变异21例(48.8%),动态尺骨阳性变异6例(14.0%),X线检查发现患者出现腕骨坏死比例为24.3%;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评分及特殊检查关系密切。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、特别是腕部动态X线摄片和MRI检查,可以明显提高对该病征的诊断率。

Discussion on diagnosis methods of ulnar impaction syndrome induced by training injury

Objective To explore the methods of the diagnosis of ulnar impaction syndrome induced by training injury.Methods From March 2000 to February 2004,187 cases of soldiers who complained of pain of wrist ulnar caused by training injury were checked and diagnosed according to the diagnosis criterion of Yu-dong Gu,especially to wrist MRI, and 43 cases were diagnosed for ulnar impaction syndrome.Results 21 cases of ulnar impaction syndrome had positive lunar variance(48.8%);6 cases had dynamic positive lunar variance(14.0%); Carpal avascular necrosis were found in about 24.3% of cases through X-ray of wrist. Different degree changes of abnormal signal intensity were found by MRI, and carpale necrosis were always at ulnar side of lunate or(and) at the waist and bottom of triquetrum. There was a close relationship between clinical symptom and Chun's grading system and special examination of the wrist.Conclusion The early diagnosis can be made easily through elevating acquaintance level based on clinical symptoms, through enough use of X-ray imaging, especially dynamic X-ray and MRI.