手指关节损伤的MRI检查

MR Imaging of joint injuries of the hand

目的了解MRI检查对手指关节损伤的诊断作用。方法对外伤后致手指损伤的18例24个近侧指间关节或掌指关节进行X线片和MRI检查;其中对6例8个指间关节损伤进行了手术治疗,对12例16个指间关节行石膏固定。结果X线片显示24个损伤关节中发现4例(4个)指关节有损伤并伴有指骨骨折;MRI显示24个指关节均有不同程度的损伤,其中侧副韧带损伤12个关节,侧副韧带损伤伴指骨骨折4个关节,侧副韧带损伤伴掌板撕裂伤8个关节。治疗后3个月,所有病例均获得随访。手功能按TAM评定标准评定疗效:优20个,良4个,优良率达100%。结论MRI检查对手指关节损伤的阳性诊断率很高,检测方便,为临床治疗提供了可靠的依据。

Objective To evaluate the diagnostic value of MR imaging for joint injuries of the hand.Methods 16 proximal interphalangeal （PIP） joints and 8 metacarpophalangeal （MP） joints injured in 18 cases of hand injuries were examined with X-ray and MR imaging. 8 joints of 6 cases were treated surgically. 16 joints of 12 cases were treated with splint immobilization. Results X-ray revealed joint injury associated with phalanx fracture in 4 joints. MR imaging showed collateral ligament tears in 12 joints, collateral ligament tears and phalanx fracture in 4 joints, and collateral ligament tears associated with avulsion of the volar plate in 8 joints. Follow up and evaluation was done 3 months after the treatment. Results graded by TAM were excellent in 20 joints and good in 4 joints, the overall excellent and good rate being 100%. Conclusion MR imaging is very useful for diagnosis of traumatic lesions of joints in the hand. It provides reliable information for treatment options.