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This study aims to investigate the correlation between ultrasonographic and clinical findings in dorsoradial wrist pain. There are several etiologies for dorsoradial wrist pain, including carpometacarpal joint arthritis, De Quervain's tenosynovitis, proximal and distal intersection syndrome, Wartenberg syndrome, and ganglion cysts. In these clinical scenarios, certain physical examination tests are utilized, such as the Finkelstein test for De Quervain's tenosynovitis; however, this test may also yield positive results in cases of severe joint arthritis. Ultrasonography is proposed as a complementary tool for differential diagnosis. The investigators aim to examine the correlation between clinical test results and ultrasonographic parameters such as tendon thickness in the first extensor compartment, carpometacarpal joint synovitis, cortical irregularities, and the presence of osteophytes. Functional status will be assessed using the QuickDASH and FIHOA questionnaires.
In the assessment of the first carpometacarpal (CMC) joint, the following ultrasonographic parameters will be evaluated: synovitis, presence of osteophytes, joint surface irregularity, and Doppler signal activity. Additionally, conventional hand radiographs of all participants will be reviewed to support the imaging findings.
For the evaluation of De Quervain's tenosynovitis, tendon sheath thickness, tendon cross-sectional area, and intratendinous Doppler activity will be measured. At the anatomical intersection zones of the first dorsal compartment, the presence of peritendinous fluid and associated Doppler activity will also be assessed to identify potential sites of friction or inflammation.
Assessment of the superficial radial nerve will include measurement of its cross-sectional area. A cross-sectional area exceeding one square millimeter will be considered indicative of possible neuropathy.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| ultrasonographic examination | Other | ultrasonographic examination |
| Measure | Description | Time Frame |
|---|---|---|
| Odds Ratio of First Extensor Compartment Tendon Sheath Thickness Associated with De Quervain Disease | To quantify the association between increased tendon sheath thickness and clinical diagnosis of De Quervain tenosynovitis using logistic regression analysis. | At the time of enrollment |
| Odds Ratio of Synovial Hypertrophy in CMC Joint Associated with Carpometacarpal Arthritis | To assess the strength of association between ultrasonographic synovial hypertrophy and clinical diagnosis of carpometacarpal joint arthritis. | At the time of enrollment |
| Sensitivity of Ultrasonographic Parameters for Diagnosing Dorsoradial Wrist Pathologies | To assess the diagnostic sensitivity of individual ultrasonographic findings (e.g., tendon sheath thickness, synovial hypertrophy) for detecting De Quervain tenosynovitis and CMC arthritis. | At the time of enrollment |
| Specificity of Ultrasonographic Parameters for Diagnosing Dorsoradial Wrist Pathologies | To assess the diagnostic specificity of individual ultrasonographic findings for identifying De Quervain tenosynovitis and CMC arthritis. | At the time of enrollment |
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Inclusion Criteria:
Exclusion Criteria:
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patients who referred physical theraphy and rehabilitation and orthopedia clinics with dorsoradial wrist and thumb pain
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| Name | Affiliation | Role |
|---|---|---|
| Ilkyaz YaÄŸar, Resident | University of Health Sciences, FSM Training and Research Hospital, Istanbul | Principal Investigator |
| Esra Giray, Associated Professor | University of Health Sciences, FSM Training and Research Hospital, Istanbul | Study Director |
| Aslınur Keleş | University of Health Sciences, FSM Training and Research Hospital, Istanbul | Study Chair |
| Feyza Unlu Ozkan, Professor | University of Health Sciences, FSM Training and Research Hospital, Istanbul | Study Chair |
| Ilknur Aktas, Professor | University of Health Sciences, FSM Training and Research Hospital, Istanbul | Study Chair |
| Ozge Gulsum Illeez, Associated Professor | University of Health Sciences, FSM Training and Research Hospital, Istanbul | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Health Sciences, FSM Training and Research Hospital, Istanbul | Istanbul | ataşehir | 34752 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30888457 | Background | McBain B, Rio E, Cook J, Grabinski R, Docking S. Diagnostic accuracy of imaging modalities in the detection of clinically diagnosed de Quervain's syndrome: a systematic review. Skeletal Radiol. 2019 Nov;48(11):1715-1721. doi: 10.1007/s00256-019-03195-z. Epub 2019 Mar 19. | |
| 23396515 | Background | Montechiarello S, Miozzi F, D'Ambrosio I, Giovagnorio F. The intersection syndrome: Ultrasound findings and their diagnostic value. J Ultrasound. 2010 Jun;13(2):70-3. doi: 10.1016/j.jus.2010.07.009. Epub 2010 Sep 19. |
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| 36774602 | Background | Look N, Mcnulty M, Rodriguez-Fontan F, Fenoglio AK. Radial-sided wrist pain differentials: presentation, pathoanatomy, diagnosis, and management. Medicina (B Aires). 2023;83(1):96-107. |
| ID | Term |
|---|---|
| C562760 | Capillary Malformations, Congenital, 1 |
| D045888 | Ganglion Cysts |
| D053684 | De Quervain Disease |
| D020425 | Radial Neuropathy |
| ID | Term |
|---|---|
| D003560 | Cysts |
| D009369 | Neoplasms |
| D017520 | Mucinoses |
| D003240 | Connective Tissue Diseases |
| D017437 | Skin and Connective Tissue Diseases |
| D053682 | Tendon Entrapment |
| D052256 | Tendinopathy |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D020422 | Mononeuropathies |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
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