Wrist ultrasound can help diagnose what disease?

The article is expertly consulted by Master, Doctor Hoang Van Lan Duc - Doctor of Radiology - Department of Diagnostic Imaging and Nuclear Medicine - Vinmec Times City International General Hospital. The doctor has more than 10 years of experience in the field of imaging, especially in diagnosing with emergency internal, surgical, abdominal, thoracic, musculoskeletal, neurological and thyroid, breast, ...

Currently, there are many different methods applied to diagnose diseases in the wrist area through imaging. In particular, ultrasound of the wrist joint is gradually becoming the method of choice for doctors. So what disease does an ultrasound of the wrist joint diagnose and how effective is it?

Disease in the wrist joint is a very common disease, most of the causes are due to trauma, inflammation or some cause related to occupational and sports activities that require excessive tension on the tendons and muscles. cause repetitive injuries.
Wrist ultrasound is a means of imaging diagnosis by applying ultrasound waves to investigate abnormalities in the wrist joint area.
However, because of the small size of the structures in the wrist joint, it is easy to create fake images, so the person performing the wrist joint ultrasound requires a lot of experience and expertise. Sometimes, to make an accurate diagnosis, it is necessary to combine ultrasound with other means such as X-ray, electromyography or magnetic resonance imaging (MRI).
Wrist ultrasound has the advantage of helping to identify lesions in soft tissue, nerves, blood vessels or synovial membranes quickly. Besides, it is also effective in the diagnosis and monitoring of treatment response for rheumatoid arthritis. Another plus point of the wrist joint ultrasound is to help detect the disease at an early stage at a reasonable cost, suitable for all subjects.

2.1. Ultrasound of the wrist joint on the palpeface Anatomy of the structures on the palmar surface of the wrist through ultrasound includes:
Transverse carpal ligament: This ligament has an internal attachment point of the shinbone and hook of the hook bone, the attachment point. The outside is the tubercle of the boat bone and the tubercle of the trapezius. The carpal tunnel is a fibrous bone, composed of the transverse ligament and the bones of the wrist. The carpal tunnel consists of 4 superficial flexor tendons, 4 deep flexor tendons, and the median nerve. The ulnar nerve is a nerve located between the ulnar flexor tendon of the wrist and the common flexor tendon of the superficial fingers. The ulnar nerve enters the palm of the hand through the common ulnar canal with the ulnar artery. Cylindrical tube, also known as Guyon's canal, is bounded by the short interscapular ligament above, the transverse carpal ligament and the crochete ligament below, the outer wall is the hook bone, and the inner wall is the bone. bean. The ulnar ulnar flexor tendon at the medial margin: Attaches to the humerus, metatarsal V, and hook bone. The radial carpal flexor tendon at the lateral border: Attaches to the base of the second metatarsal bone.

Ultrasound of the wrist joint on the palmar surface can diagnose some of the following diseases:
Carpal tunnel syndrome Carpal tunnel syndrome occurs when the median nerve located in the carpal tunnel is compressed and causes so the symptoms of the disease.
Carpal tunnel syndrome is considered a common peripheral neuropathy, the majority of patients are women who work in offices and use their hands continuously in a fixed position for a long time.
Acute carpal tunnel syndrome can be difficult to detect on ultrasound of the wrist joint. However, in the chronic stage, ultrasonography of the wrist joint will show neurologic images between edema, shape, size, altered echogenicity, and reduced nerve movement during dynamic testing. Criteria for diagnosis of carpal tunnel syndrome on ultrasound of the wrist joint:
Notch sign: It is a sign of edema of the median nerve such as an onion-like bulb in the proximal carpal tunnel and flattening in the inner carpal tunnel. Inverter notch sign: It is a sign that the median nerve is swollen like an onion in the distal part of the carpal tunnel and flattened in the inner part of the carpal tunnel. Guyon's canal syndrome is a syndrome caused by compression of the ulnar nerve in the ulna, which is rarer than carpal tunnel syndrome. The cause is often due to trauma, broken hook bones or sports activities, performing jobs that often put strong pressure on the palm of the hand.
Normally, ultrasonography of the wrist joint in the ulna will show arteries, veins, and ulnar nerve. Detecting another structure in the duct that is compressing the nerve will help diagnose this pathology.

2.2. Ultrasound of the wrist joint on the dorsal surface An ultrasound of the wrist joint on the dorsal surface will show the following anatomical structures:
The extensor tendons of the dorsal dorsal region of the wrist are held by the tendon retaining membrane, divided into 6 compartments and covered by the tendon sheath. around:
Compartment 1: Including the long tendon of the thumb and the short extensor tendon of the thumb. The most common disease in this compartment is De Quervain's tendinitis - inflammation of the short extensor tendon sheath of the thumb. Compartment 2: Includes 2 tendons, the long rotator cuff extensor tendon and the short rotator cuff extensor tendon. Compartment 3: Consists of the long extensor tendon of the thumb that attaches to the distal phalange of the thumb. Compartment 4: Includes 5 tendon bundles, with the common extensor tendon of the fingers and the extensor tendon of the index finger. Compartment 5: Is the extensor tendon of the little finger. Compartment 6: Is the extensor tendon of the ulnar wrist. Triangular fibrocartilage complex: This complex is composed of many structures within the ulnar carpal cavity. Its primary function is to provide lateral stability of the wrist and lower rotator cuff. When doing an ultrasound of the dorsal wrist joint, the triangular cartilage will be seen, the echoes will be thick, and the ultrasound will help detect signs of tearing or creating internal cysts.
The most common disease when doing an ultrasound of the wrist joint on the dorsal side is inflammation of the short extensor tendon of the thumb, also known as De Quervain's tendinitis. The mechanism that causes this disease is repetitive movements such as writing a lot, typing on the computer, playing the piano or mothers taking care of babies. The long and short extensor tendons of the thumb are then tightened by the thick sheath in the pulley just above the rotator cuff process. Therefore, patients often have pain with redness and swelling near the radial gyrus, palpable and easily misdiagnosed with radial stye.
Diagnostic criteria for short extensor tendonitis and long form of the thumb on ultrasound of the wrist joint include:
The tendon is thick, usually round or oval in shape, with signs of increased perfusion. Thick tendon sheath, poor echogenicity, increased perfusion, or fluid in the tendon sheath. The fascia holds the extensor tendon. There may be edema of the fatty tissue around the tendon. Currently, at Vinmec International General Hospital, ultrasound technology has been applied in examination and diagnosis of many musculoskeletal diseases, including wrist ultrasound technique. The ultrasound procedure of the wrist joint at Vinmec is carried out methodically and according to the standards of the procedure by a team of highly skilled medical doctors, modern machinery system, thus giving accurate results, making a significant contribution. in disease diagnosis and staging.