US Wrist US can be used to identify synovitis, joint effusion, tenosynovitis, tendinopathy and tendon injury, CTS, metacarpophalangeal joint collateral ligament injury, extensor hood injury, and retained foreign body [6,13,14,16,46]. The American College of Rheumatology has concluded there is reasonable evidence to support the use of musculoskeletal US in patients without definitive diagnosis presenting with pain, swelling, or mechanical symptoms of the wrist; US is reasonable to evaluate tendon and soft tissue pathology of the wrist and to assess for entrapment of the median or ulnar nerves [14]. In a study of patients referred from hand surgeons, US of the hand and wrist was contributory to the clinical assessment, defined as confirming the clinical suspicion or modifying the diagnostic/therapeutic plan, in 76% of all patients and 67% of patients who presented without a history of trauma Chronic Hand and Wrist Pain [17]. Although there are many advantages to US evaluation for chronic hand and wrist pain, an interdisciplinary group of hand surgeons and radiologists recommended against the inclusion of US in the standard evaluation of scapholunate instability [18]. Variant 3: Adult. Chronic hand pain. Radiographs normal or remarkable for nonspecific arthritis. Next imaging study. Bone Scan Hand There is no relevant literature to support the use of bone scan in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. CT Arthrography Hand There is no relevant literature to support the use of CT arthrography in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. CT Hand With IV Contrast There is no relevant literature to support the use of CT hand with IV contrast in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis.
Chronic Hand and Wrist Pain. US Wrist US can be used to identify synovitis, joint effusion, tenosynovitis, tendinopathy and tendon injury, CTS, metacarpophalangeal joint collateral ligament injury, extensor hood injury, and retained foreign body [6,13,14,16,46]. The American College of Rheumatology has concluded there is reasonable evidence to support the use of musculoskeletal US in patients without definitive diagnosis presenting with pain, swelling, or mechanical symptoms of the wrist; US is reasonable to evaluate tendon and soft tissue pathology of the wrist and to assess for entrapment of the median or ulnar nerves [14]. In a study of patients referred from hand surgeons, US of the hand and wrist was contributory to the clinical assessment, defined as confirming the clinical suspicion or modifying the diagnostic/therapeutic plan, in 76% of all patients and 67% of patients who presented without a history of trauma Chronic Hand and Wrist Pain [17]. Although there are many advantages to US evaluation for chronic hand and wrist pain, an interdisciplinary group of hand surgeons and radiologists recommended against the inclusion of US in the standard evaluation of scapholunate instability [18]. Variant 3: Adult. Chronic hand pain. Radiographs normal or remarkable for nonspecific arthritis. Next imaging study. Bone Scan Hand There is no relevant literature to support the use of bone scan in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. CT Arthrography Hand There is no relevant literature to support the use of CT arthrography in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis. CT Hand With IV Contrast There is no relevant literature to support the use of CT hand with IV contrast in the setting of chronic hand pain and normal radiographs or radiographs remarkable for nonspecific arthritis.