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Semin Musculoskelet Radiol 2004; 8(1): 57-79
DOI: 10.1055/s-2004-823015
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

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
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Publication History

Publication Date:
13 April 2004 (online)

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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

REFERENCES

  • 1 Rettig A C. Epidemiology of hand and wrist injuries in sports.  Clin Sports Med. 1998;  17 401-406
    CrossrefPubMedGoogle Scholar
  • 2 Geissler W. Carpal fracture in athletes. Clinics in Sports Medicine.  Clin Sports Med. 2001;  20 167-188
    PubMedGoogle Scholar
  • 3 Steinberg B. Acute wrist injuries in the athlete.  Orthop Clin North Am. 2002;  33 535-545
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 5 Schreibman K, Freeland A, Gilula L, Yin Y. Imaging of the hand and wrist.  Orthop Clin North Am. 1997;  28 537-582
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 7 Ritchie J V, Munter D W. Emergency department evaluation and treatment of wrist injuries.  Emerg Med Clin North Am. 1999;  17 823-842
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 9 Peh W, Gilula L, Wilson A. Detection of occult wrist fractures by magnetic resonance imaging.  Clin Radiol. 1996;  51 285-292
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Perlik P C, Guilford W B. Magnetic resonance imaging to assess vascularity of scaphoid nonunions.  J Hand Surg [Am]. 1991;  16A 479-484
    PubMedGoogle Scholar
  • 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
    Google Scholar
  • 14 Resnik C. Wrist and hand injuries.  Seminars Musculoskelet Radiol. 2000;  4 193-204
    PubMedGoogle Scholar
  • 15 Bishop A, Beckenbaugh R. Fracture of the hamate hook.  J Hand Surg [Am]. 1988;  13 135-139
    PubMedGoogle Scholar
  • 16 Hanel D P, Jones M D, Trumble T E. Wrist fractures.  Orthop Clin North Am. 2002;  33 35-57
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 21 Mayfield J, Johnson R, Kilcoyne R. Carpal dislocations: pathomechanics and progressive perilunate instability.  J Hand Surg [Am]. 1980;  5 226-241
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 23 Cober S R, Trumble T E. Arthroscopic repair of triangular fibrocartilage complex injuries.  Orthop Clin North Am. 2001;  32 279-294
    CrossrefPubMedGoogle Scholar
  • 24 Sofka C M, Potter H G. Magnetic resonance imaging of the wrist.  Semin Musculoskelet Radiol. 2001;  5 217-226
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Palmer A K. Triangular fibrocartilage complex lesions: a classification.  J Hand Surg [Am]. 1989;  14 594-605
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 30 Nagle D J. Triangular fibrocartilage complex tears in the athlete.  Clin Sports Med. 2001;  20 155-166
    PubMedGoogle Scholar
  • 31 Adams B D, Divelbiss B J. Reconstruction of the posttraumatic unstable distal radioulnar joint.  Orthop Clin North Am. 2001;  32 353-363
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 34 Lewis D M, Osterman A L. Scapholunate instability in athletes.  Clin Sports Med. 2001;  20 131-140
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    Google Scholar
  • 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
    PubMedGoogle Scholar
  • 38 Smith D K. MR imaging of normal and injured wrist ligaments.  Magn Reson Imaging Clin N Am. 1995;  3 229-248
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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; 
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 42 Oneson S R, Scales L M, Erickson S T, Timins M E. MR imaging of the painful wrist.  Radiographics. 1996;  16 997-1008
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 45 Lee S J, Montgomery K. Athletic hand injuries.  Orthop Clin North Am. 2002;  33 547-554
    CrossrefPubMedGoogle Scholar
  • 46 Palmer R E. Joint injuries of the hand in athletes.  Clin Sports Med. 1998;  17 513-531
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 48 Langford S, Whitaker J, Toby E. Thumb injuries in the athletes.  Clin Sports Med. 1998;  17 553-566
    PubMedGoogle Scholar
  • 49 Capo J, Hastings II H. Metacarpal and phalangeal fractures in athletes.  Clin Sports Med. 1998;  17 491-511
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 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
    CrossrefPubMedGoogle Scholar
  • 53 Rettig A. Wrist and hand overuse syndromes.  Clin Sports Med. 2001;  20 591-611
    Google Scholar
  • 54 Glajchen N, Schweitzer M. MRI features in de Quervain's tenosynovitis of the wrist.  Skeletal Radiol. 1996;  25 63-65
    CrossrefPubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar
  • 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
    PubMedGoogle Scholar

Joel L RosnerM.D. 

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Email: jrosner@nationalrad.com

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