Wrist Pathology
DEQUERVIAN TENOSYNOVITIS
A: Short axis image of the first extensor wrist tendons showing hypoechoic thickening of the tendon sheath (arrowheads) with hypoechoic swelling of the abductor pollicis longus tendon (arrows). 1
A: Short axis image of the first extensor wrist tendons showing hypoechoic thickening of the tendon sheath (arrowheads) with hypoechoic swelling of the abductor pollicis longus tendon (arrows). 1
B: Long axis image of the same case above. 1
TENOSYNOVITIS OF TENDONS
A: Tenosynovitis caused by rheumatoid arthritis. Short axis image of the extensor tendons (T) show anechoic fluid distension of the tendon sheath (arrows). 1
A: Tenosynovitis caused by rheumatoid arthritis. Short axis image of the extensor tendons (T) show anechoic fluid distension of the tendon sheath (arrows). 1
B: Tenosynovitis caused by pseudogout. Image is in the short axis to the extensor tendons, over the dorsal wrist. Tendons (T) show anechoic fluid distension of the tendon sheath. 1
C: Tenosynovitis cause by gout. Short axis image of the wrist extensor tendons (T) at the level of the radiocarpal joint show hypoechoic synovial hypertrophy. 1
D: Tenosynovitis caused by infection. This image is in the short axis to the extensor tendons of the finger, showing the hypoechoic synovial hypertrophy. 1
E: Same image as D but with colour Doppler showing hyperemia. Flow detection on colour Doppler is a common ultrasound appearance of tenosynovitis. 1
RHEUMATOID ARTHRITIS
A: Longitudinal image over the dorsal wrist showing hypoechoic distension of the radiocarpal (arrows) and midcarpal (arrowheads) dorsal joint recesses. These joints will also show hyperemia with colour Doppler. 1
A: Longitudinal image over the dorsal wrist showing hypoechoic distension of the radiocarpal (arrows) and midcarpal (arrowheads) dorsal joint recesses. These joints will also show hyperemia with colour Doppler. 1
B: Coronal image of the second metacarpal head shows hypoechoic and isoechoic synovial hypertrophy (arrows) that extends into the metacarpal erosin. 1
EXTENSOR CARPI ULNARIS SUBLUXATION
A: Short axis image of the extensor tendon shows subluxation from its normal position, which is shown with an asterisk. 1
A: Short axis image of the extensor tendon shows subluxation from its normal position, which is shown with an asterisk. 1
B: Same image as above but with colour Doppler showing increased flow around the extensor tendon. 1
References
1. Jacobson, J. (2013). Fundementals of Musculoskeletal Ultrasound: Edition 2. Elsevier Saunders: Philadelphia, PA.
1. Jacobson, J. (2013). Fundementals of Musculoskeletal Ultrasound: Edition 2. Elsevier Saunders: Philadelphia, PA.