E2250. Ulnar-Sided Wrist Impaction and Impingement Syndromes
Authors
Bowen Wei;
University of California, Los Angeles
Johnathan Chen;
University of California, Los Angeles
Kambiz Motamedi;
University of California, Los Angeles
Background
Individual ulnar variance changes with wrist positions and may predispose one to ulnar-sided wrist impaction and impingement syndromes. The clinical manifestations of these distinct conditions may be similar; specific wrist provocative tests can elicit subtle differences in their symptoms. Diagnosis is often made in conjunction with radiographic evidence of impingement.
Educational Goals / Teaching Points
Ulnar-sided wrist impaction and impingement syndromes are a group of distinct conditions with minor overlaps that may cause debilitating ulnar-sided wrist pain. Recognition of their differences on imaging and the subtleties of biomechanics involved is important for radiologists to ensure their diagnostic accuracy and avoid misclassification.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Depending on the type of impingement and the chronicity of the condition, bone marrow signal abnormalities including edema, subchondral cystic changes and sclerosis may be observed on imaging. Findings concerning for late disease progression include disruption and tearing of the triangular fibrocartilage complex and the lunotriquetral ligament. Treatments consist of mainly conservative managements versus surgical procedures to correct the underlying etiology of impingement.
Conclusion
Ulnar-sided wrist impaction and impingement syndromes are a group of distinct conditions with similar clinical presentations. Understand and recognize their differences on imaging are key for radiologists to establish accurate diagnosis, as treatments are focused to correct the specific underlying cause of impingement.
