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Imaging Findings in Ulnar-sided Wrist Impaction Syndromes¹

¹ From the Department of Radiology, Instituto Radiológico Cántabro, Clínica Mompía, Mompía, 39100 Cantabria, Spain (L.C., F.A., R.G.V., T.P., A.C.); and the Private Hand-Wrist and Plastic-Reconstructive Surgery and Hand Surgery Department, Mutua Montañesa, Rualasal, Santander, Spain (F.d.P.). Recipient of a Cum Laude award for an education exhibit at the 2000 RSNA scientific assembly. Received April 19, 2001; revision requested May 17 and received June 25; accepted July 2. Address correspondence to L.C. (e-mail: lcerezal@mundivia.es).

Impaction syndromes related to ulnar-sided pain include ulnar impaction syndrome, ulnar impingement syndrome, ulnocarpal impaction syndrome secondary to nonunion of the ulnar styloid process, ulnar styloid impaction syndrome, and hamatolunate impingement syndrome. The most common of these, ulnar impaction syndrome, is a degenerative condition of the ulnar side of the wrist related to excessive load bearing across the ulnar carpus, triangular fibrocartilage (TFC) complex, and ulnar head. In an adequate clinical setting, characteristic osseous findings at radiography include positive ulnar variance in ulnar impaction syndrome, a short ulna in ulnar impingement syndrome, nonunion of the ulnar styloid process in ulnar impaction syndrome secondary to ulnar styloid nonunion, an excessively long ulnar styloid process in ulnar styloid impaction syndrome, and type II lunate bone in hamatolunate impingement syndrome. Nevertheless, confirmation of clinical and conventional radiographic findings with magnetic resonance (MR) imaging is often necessary to exclude other entities with similar clinical manifestations. MR imaging allows earlier detection of an abnormality in the TFC complex, cartilage, or bone marrow of carpal bones and is helpful in formulating the extensive differential diagnosis in patients with ulnar wrist pain and limitation of motion.

© RSNA, 2002

Index Terms: Wrist, fractures, 43.41 • Wrist, injuries, 43.41, 43.432, 43.483 • Wrist, MR, 43.1214 • Wrist, radiography, 43.11

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