Skip to main content
SpringerLink
Log in

Hand- und Handwurzel-Ultraschall

  • Ultraschall—neue Entwicklungen
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

In den vergangenen Jahren wird der Ultraschall zunehmend als bildgebendes Verfahren zur Untersuchung von Erkrankungen des Bewegungsapparates eingesetzt. Klare Vorteile des Ultraschalls sind geringe Kosten, fehlende Invasivität, Verfügbarkeit und die Möglichkeit dynamischer Untersuchungen unter Funktionsprüfung. Ein Nachteil ist, dass er viel Übung erfordert und gute Ergebnisse nur von erfahrenen Untersuchern zu erwarten sind. Mit modernen Nahfeldschallköpfen können Funktionsuntersuchungen der Hand während Beugung und Streckung der Finger durchgeführt werden. Dank hoher Sendefrequenzen (bis 15 MHz) können kleine anatomische Details und diskrete, krankhafte Veränderung von Hand und Handgelenk nachgewiesen werden. In diesem Artikel wird in die normale Anatomie und die Ultraschallanatomie von Hand und Handgelenk eingeführt und auf pathologische Veränderungen eingegangen. Diese umfassen Erkrankungen von Gelenken und Sehnen, Fremdkörper und Verletzungen, kompressionsbedingte Neuropathien und Raumforderungen.

Abstract

In the recent years US has gained wide diffusion as a useful imaging tool in the evaluation of musculoskeletal disorders. Recognized advantages of US over the other imaging modalities are low costs, non-invasiveness, possibility to perform a dynamic examination and readiness. Unfortunately, US has a long learning curve and allows good results only when performed by well-trained and experienced examiners.

Specifically, utilization of the recent small transducers allows to perform dynamic examination of the hand during flexion-extension movements of the fingers, while their high frequency (till 15 MHz) have increased the possibility to evaluate small anatomic structures of the hand and wrist as well as to detect subtle pathologic changes.

The purpose of this article is to present first the normal basic anatomy and US appearance. Then the main pathological conditions including joint and tendon disorders, foreign bodies and other traumatic lesions, entrapment neuropathies and expansible lesions will be presented.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1a,b
Abb. 2a-c
Abb. 3a-c
Abb. 4a-c
Abb. 5a,b
Abb. 6a,b
Abb. 7a,b
Abb. 8a,b
Abb. 9a,b

Literatur

  1. Martinoli C, Bianchi S, Derchi LE (1999) Ultrasound of tendon and nerves. Radiol Clin North Am 37:691–711

    CAS  PubMed  Google Scholar 

  2. Ferrara MA, Marcelis S (1997) Ultrasound examination of the wrist. J Belge Radiol 80:78–80

    CAS  PubMed  Google Scholar 

  3. Milbradt H, Calleja Cancho E, Qaiyumi SA, Galanski M (1990) Sonography of the wrist and the hand. Radiologe 30:360–365

    CAS  PubMed  Google Scholar 

  4. Chiou HJ, Chou YH, Chang CY (2001) Ultrasonography of the wrist. Can Assoc Radiol J 5:302–311

    Google Scholar 

  5. Bianchi S, Martinoli C, Sureda D, Rizzatto G (2001) Ultrasound of the hand. Eur J Ultrasound 14:29–34

    Article  CAS  PubMed  Google Scholar 

  6. Read JW, Conolly WB, Lanzetta M, Spielman S, Snodgrass D, Korber JS (1996) Diagnostic ultrasound of the hand and wrist. J Hand Surg 21:1004–1010

    CAS  Google Scholar 

  7. Koski JM (1992) Ultrasonography in the detection of effusion in the radiocarpal and midcarpal joints. Scand J Rheumatol 21:79–81

    CAS  PubMed  Google Scholar 

  8. Grassi W, Tittarelli E, Pirani O, Avaltroni D, Cervini C (1993) Ultrasound examination of metacarpophalangeal joints in rheumatoid arthritis. Scand J Rheumatol 22:243–247

    CAS  PubMed  Google Scholar 

  9. Lund PJ, Heikal A, Maricic MJ, Krupinski EA, Williams CS (1995) Ultrasonographic imaging of the hand and wrist in rheumatoid arthritis. Skeletal Radiol 24:591–596

    CAS  PubMed  Google Scholar 

  10. Backhaus M, Kamradt T, Sandrock D, Loreck D, Fritz J, Wolf KJ, Raber H, Hamm B, Burmester GR, Bollow M (1999) Arthritis of the finger joints. A comprehensive approach comparing conventional radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imaging. Arthritis Rheum 42:1232–1245

    CAS  PubMed  Google Scholar 

  11. Steuer A, Bush J, DeSouza NM, Taylor P, Blomley MJ, Cosgrove DO et al. (2001) Power Doppler ultrasound in early rheumatoid arthritis: a comparative study with contrast-enhanced MRI. Radiology 218:561, abstr

    Google Scholar 

  12. Szkudlarek M, Court-Payen M, Strandberg C, Klarlund M, Klausen T, Ostergaard M (2001) Power Doppler ultrasonography for assessment of synovitis in the metacarpophalangeal joints of patients with rheumatoid arthritis: a comparison with dynamic resonance imaging. Arthritis Rheum 44:2018–2023

    CAS  PubMed  Google Scholar 

  13. Klauser A, Frauscher F, Schirmer M, Halpern E, Pallwein L, Herold M, Helweg G, ZurNedden D (2002) The value of contrast-enhanced color Doppler ultrasound in the detection of vascularization of finger joints in patients with rheumatoid arthritis. Arthritis Rheum 46:647–653

    Article  PubMed  Google Scholar 

  14. Wakefield RJ, Gibbon WW, Conaghan PG, O'Connor P, McGonagle D, Pease C, Green MJ, Veale DJ, Isaacs JD, Emery P (2000) The value of sonography in the detection of bone erosions in patients with rheumatoid arthritis. A comparison with conventional radiography. Arthritis Rheum 43:2762–2770

    Article  CAS  PubMed  Google Scholar 

  15. Giovagnorio F, Andreoli C., De Cicco ML (1997) Ultrasonographic evaluation of de Quervain's disease. J Ultrasound Med 16:685–689

    CAS  PubMed  Google Scholar 

  16. Anderson MA, Newmeyer WL III, Kilgore ES jr (1982) Diagnosis and treatment of retained foreign bodies of the hand. Am J Surg 144:63–67

    CAS  PubMed  Google Scholar 

  17. Howden MD (1994) Foreign bodies within finger tendon sheaths demonstrated by ultrasound: two cases. Clin Radiol 49:419–420

    CAS  PubMed  Google Scholar 

  18. Manthey DE, Storrow AB, Milbourn JM, Wagner BJ (1996) Ultrasound versus radiography in the detection of soft-tissue foreign bodies. Ann Emerg Med 28:7–9

    CAS  PubMed  Google Scholar 

  19. Shiels WE 2d, Babcock DS, Wilson JL, Burch RA (1990) Localization and guided removal of soft-tissue foreign bodies with sonography. AJR 155:1277–1281

    PubMed  Google Scholar 

  20. Fornage BD, Schernberg FL (1986) Sonographic diagnosis of foreign bodies in the distal extremities. AJR 147:567–569

    CAS  Google Scholar 

  21. Howden MD(1994) Foreign bodies within finger tendon sheaths demonstrated by ultrasound: two cases. Clin Radiol 49:419–420

    CAS  PubMed  Google Scholar 

  22. Hergan K, Mittler C, Oser W (1995) Ulnar collateral ligament: differentiation of displaced and nondisplaced tears with US and MRI imaging. Radiology 194:65–71

    CAS  PubMed  Google Scholar 

  23. Noszian IM, Dinkhauser LM, Orthner E, Straub GM, Csanady M (1995) Ulnar collateral ligament: differentiation of displaced and nondisplaced tears with US. Radiology 194:61–63

    CAS  PubMed  Google Scholar 

  24. O'Callaghan BI, Kohut G, Hoogewoud H-M (1994) Gamekeeper's thumb: identification of the Stener lesion with US. Radiology 192:477–480

    CAS  PubMed  Google Scholar 

  25. Martinoli C, Bianchi S, Derchi L, Garcia J (2000) Sonographic evaluation of digital annular pulleys tears. Skeletal Radiol 29:387–391

    Article  CAS  PubMed  Google Scholar 

  26. Klauser A, Frauscher F, Bodner G, Halpern EJ, Schocke MF, Springer P, Gabl M, Judmaier W, zur Nedden D (2002) Finger pulley injuries in extreme rock climbers: depiction with dynamic US. Radiology 222:755

    PubMed  Google Scholar 

  27. Bodner G, Rudish A, Gabl M, Judmaier W, Springer P, Klauser A (1999) Diagnosis of digital flexor tendon annular pulley disuption: comparison of high frequency ultrasound and MRI. Ultraschall Med 20:131–136

    Article  CAS  PubMed  Google Scholar 

  28. Le Viet D, Rousselin B, Roulot E, Lantieri L, Godefroy D (1996) Diagnosis of digital pulley rupture by computed tomography. J Hand Surg [Am] 21:245–248

    Google Scholar 

  29. Parellada JA, Balkissoon AR, Hayes CW, Conway WF (1996) Bowstring injury of the flexor tendon pulley system: MR imaging. AJR 167:347–349

    CAS  Google Scholar 

  30. Martinoli C, Bianchi S, Gandolfo N, Valle M, Simonetti S, Derchi LE (2000) US of nerve entrapments in osteofibrous tunnels. Radiographics 20:199–213

    Google Scholar 

  31. Buchberger W, Judmaier W, Birbamer G, Lener M, Schmidauer C (1992) Carpal tunnel syndrome: diagnosis with high-resolution sonography. AJR 159:793–798

    CAS  Google Scholar 

  32. Buchberger W, Schon G, Strasser K, Jungwirth W (1991) High-resolution ultrasonography of the carpal tunnel. J Ultrasound Med 10:531–537

    CAS  PubMed  Google Scholar 

  33. Martinoli C, Serafini G, Bianchi S, Bertolotto M, Derchi LE (1996) Ultrasonography of peripheral nerves. J Peripher Nerv Syst 1(3):169–178

    CAS  PubMed  Google Scholar 

  34. Bianchi S, Abdelwahab IF, Zwass A, Giacomello P(1994) Ultrasonographic evaluation of wrist ganglia. Skeletal Radiol 23:201–203

    CAS  PubMed  Google Scholar 

  35. Paivansalo M, Jalovaara P (1991) Ultrasound findings of ganglions of the wrist. Eur J Radiol 13:178–180

    CAS  PubMed  Google Scholar 

  36. De Flaviis L, Nessi R, Del Bo P, Calori G, Balconi G (1987) High-resolution ultrasonography of the wrist ganglia. J Clin Ultrasound 15:17–22

    PubMed  Google Scholar 

  37. Bianchi S, Abdelwahab IF, Zwass A, Calogera R, Banderali A, Brovero P, Votano P (1993) Sonographic findings in examination of digital ganglia: retrospective study. Clin Radiol 48:45–47

    CAS  PubMed  Google Scholar 

  38. Cardinal E, Buckwalter KA, Braunstein EM, Mih AD (1994) Occult dorsal carpal ganglion: comparison of US and MR imaging. Radiology 193:259–262

    CAS  PubMed  Google Scholar 

  39. Breidahl WH, Adler RS (1996) Ultrasound-guided injection of ganglia with corticosteroids. Skeletal Radiol 25:635–638

    Article  CAS  PubMed  Google Scholar 

  40. Bianchi S, Abdelwahab IF, Zwass A, Merello A, Damiani S (1993) Sonographic evaluation of a pseudoaneurysm of a digital artery: a case report. J Hand Surg [Am] 18:638–640

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division de Radiodiagnostic et de radiologie interventionnelle, Département de Radiologie, Hôpital Cantonal Universitaire de Genève

    S. Bianchi & X. Montet

  2. Fondation Grangettes, Chêne-Bougeries

    S. Bianchi

  3. Cattedra di Radiologia "R", DICMI-Università di Genova

    C. Martinoli

  4. Département de Morphologie, Centre medical Universitaire de Genève

    J. H. D. Fasel

  5. Division de Radiodiagnostic et de radiologie interventionnelle, Département de Radiologie, Hôpital Cantonal Universitaire, 24, Rue Micheli-du-Crest, 1211 , Genève, Schweiz

    S. Bianchi

Authors
  1. S. Bianchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Martinoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. X. Montet
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. H. D. Fasel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Bianchi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bianchi, S., Martinoli, C., Montet, X. et al. Hand- und Handwurzel-Ultraschall. Radiologe 43, 831–840 (2003). https://doi.org/10.1007/s00117-003-0961-0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00117-003-0961-0

Schlüsselwörter

Keywords

Search

Navigation