HIGH RESOLUTION ULTRASONOGRAPHY OF THE HAND AND WRIST: THREE-YEAR EXPERIENCE AT A DISTRICT GENERAL HOSPITAL TRUST

摘要

A retrospective analysis of 227 patients undergoing ultrasonography (US) of the hand/wrist over a three-year period in a districtngeneral hospital trust was performed. The usefulness in each case was assessed by two independent reviewers using a qualitativenrating system, as (A) Useful: determines management, (B) Useful: contributory, (C) Not useful: not misleading, or (D) Notnuseful: misleading/potentially harmful. US was useful in 74.8% of cases but misleading/potentially harmful in 13.1%. Misleadingnrates exceeding 10% in sub-categories including tendinopathy, carpal tunnel syndrome, foreign body and lumps, where US findingsnmay influence the decision to operate or not, are particularly worrying. There were a number of cases where US led to unnecessarynoperations or suggested operating on the wrong structures, and also cases where US findings wrongly suggested that surgery wasnunnecessary. Various recommendations aimed to improve the usefulness of US in the Hand and Wrist, including mandatory/formalnmusculoskeletal US training, are made