wrist , hand ultrasound (musculoskeletal imaging in primary care)

Last reviewed 01/2018

Wrist, hand ultrasound:

• in the hand and wrist ganglion cyst and carpal tunnel or Guyon's canal syndromes (ulnar nerve) may be diagnosed. The ulnar or median nerves can be impinged by lipoma, aberrant muscles or infiltrations from granulomatous disease, e.g. sarcoidosis
  
  
• De Quervain's tenosynovitis, a common cause of subacute wrist pain, may be diagnosed and treated with ultrasound-guided steroid injection into the associated tendon sheath/s

Notes:

Ultrasound applications

• Articular pain, swelling or mechanical symptoms without definitive diagnosis
• Shoulder pain or mechanical symptoms
• Symptoms near a joint
• Regional neuropathic pain to diagnose neural entrapment
• Guiding articular/periarticular aspiration or injection
• Diagnosis and treatment assessment of synovitis

Ultrasound advantages

• Cheaper, more accessible and better tolerated than MRI
• Preferred modality for tendinopathy and muscle trauma
• As accurate as MRI in diagnosis of rotator cuff tears
• Dynamic examination and intervention possible

Reference:

• 1) Arthritis Research UK (Summer 2013). Hands on - Musculoskeletal imaging for GPs.