Der ulnarseitige Handgelenksschmerz

Ulnarseitige Handgelenkschmerzen sind nicht selten eine diagnostische Herausforderung. Weil die klinische Diagnostik keine eindeutige Diagnose erlaubt, spielt die Bildgebung eine wesentliche Rolle. Dabei müssen an die kontrastmittelverstärkte MRT, die direkte Arthrografie, Ultraschall und Fluoroskopie höchste technische Anforderungen gestellt werden, um die subtilen Pathologien abgrenzen zu können.

Kernaussagen

• Der ulnarseitige Handgelenkschmerz beschreibt eine komplexe klinische Situation mit einer Vielzahl zugrunde liegender Ursachen, für deren Differenzialdiagnostik ein detailliertes Verständnis von Anatomie, Biomechanik und Pathophysiologie Voraussetzung ist.

• Der radiologischen Diagnostik kommt beim ulnarseitigen Handgelenkschmerz eine entscheidende Rolle zu. Schnittbildtechniken mit einer hohen räumlichen Auflösung können durch dynamische Verfahren wie Ultraschall und Fluoroskopie ergänzt werden.

• Verletzungen des ulnokarpalen Komplexes (TFCC) sind die häufigste Ursache der Instabilität im distalen Radioulnargelenk. Die multikompartimentale Injektion von Kontrastmittel mit nachfolgender CT- oder MR-Arthrografie ist der bildgebende Referenzstandard für TFCC-Läsionen.

Schlüsselwörter

Handgelenkschmerz - TFCC - distales Radioulnargelenk - Extensor carpi ulnaris - Arthrografie

Keywords

wrist pain - TFCC - distal radio-ulnar joint - extensor carpi ulnaris - arthrography

Publication History

Article published online:
11 June 2024

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