RESUMEN
PURPOSE: To define the value of CT and MR in the demonstration of an abnormal radiolunate ligament contributing to a Madelung deformity and emphasize the features on wrist radiographs suggesting the presence of such ligament. OBSERVATIONS AND RESULTS: Four cases of adolescents presenting with uni- or bilateral wrist pain are reviewed. Standard radiographs demonstrated the present of isolated Madelung deformity with increased inferior radioulnar curvature with triangularization of epiphyses and decreased carpal angle. Each patient underwent either noncontrast CT, CT arthrography or MRI. All cross-sectional imaging studies demonstrated the presence of an abnormal radiolunate ligament with radial insertion within a bony gutter. Retrospectively, the bony gutter could be identified on radiographs. In two cases, excision of the ligament provided partial correction of the deformity and symptoms, without need for classical osteotomy. CONCLUSION: In patients with Madelung deformity, CT or better yet non-ionizing and noncontrast MR may demonstrate a abnormal radiolunate ligament within a bony gutter. Detection of this gutter on radiographs suggests the presence an abnormal ligament. Early release of the abnormal ligament appears to decrease wrist deformity, improve range of motion and reduce symptoms.
Asunto(s)
Ligamentos Articulares/anomalías , Hueso Semilunar/anomalías , Radio (Anatomía)/anomalías , Adolescente , Anatomía Transversal , Artrografía , Niño , Epífisis/anomalías , Femenino , Humanos , Imagen por Resonancia Magnética , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Articulación de la Muñeca/diagnóstico por imagen , Articulación de la Muñeca/patologíaAsunto(s)
Imagen por Resonancia Magnética , Pediatría , Radiología/tendencias , Tomografía Computarizada por Rayos X , Ultrasonografía , Factores de Edad , Animales , Enfermedades Óseas/diagnóstico , Niño , Preescolar , Enfermedades del Sistema Digestivo/diagnóstico , Femenino , Enfermedades Urogenitales Femeninas/diagnóstico , Enfermedades Fetales/diagnóstico , Humanos , Lactante , Recién Nacido , Enfermedades del Sistema Nervioso/diagnóstico , Embarazo , Conejos , Dosis de Radiación , Enfermedades Torácicas/diagnósticoRESUMEN
After sonographic diagnosis, non-surgical therapy for intussusception in children uses pneumatic or hydrostatic (barium or water soluble) reduction. The purpose of this paper, in the light of our experience, is to answer the questions raised by general radiologists in emergency activity about the technique, indications, sedation and risks.