Proksimal radioulnar sinostoz

Özet

Konjenital proksimal radioulnar sinostoz, embriyonik gelişim bozukluğuna bağlı bir önkol deformitesidir ve önkol rotasyonunu kısıtlayabilir. Konjenital olgular radial baş hipoplazisi ve posterior çıkığıyla birlikte görülebilir; edinsel radioulnar sinostoz önkol kırığı osteosentezinden sonra gelişebilir. Grafiler kemik birleşmeyi gösterebilir; BT, önkol deformitesini ölçerek cerrahi planlamaya katkı sağlayabilir.

Okuma sırası

1. Kemik köprü. Proksimal radius ile ulna arasındaki osseöz füzyonu grafilerde değerlendirin.
2. Kemik köprü. CRUS-DE gibi otomatik yöntemlerle BT görüntülerinden önkol deformite açıları hesaplanabilir ve osteotomi öncesi planlamada kullanılabilir.
3. Radial baş. Radial başta hipoplazi ve posterior çıkık olup olmadığını tarif edin.
4. İnterosseöz aralık. Önkol kırığı veya cerrahi tespit öyküsünü değerlendirin; edinsel radioulnar sinostoz bu durumların ardından gelişebilir.

Faz ve pencere

Kontrastsız tanısal

BT görüntülerinden önkol deformite açıları nicel olarak ölçülebilir ve bu ölçümler cerrahi planlamada kullanılabilir.

BT bulguları

• Kemik sinostoz, radius ile ulna arasında kemik bağlantı olarak izlenir.
• Kemik sinostozda radius ile ulna arasında kemik bağlantı görülür.
• Konjenital sinostozda radial baş hipoplastik ve posterior çıkık olabilir.
• Konjenital sinostozda önkol nötr veya aşırı pronasyonda olabilir; mevcut önkol pozisyonu tarif edilir.
• Edinsel radioulnar sinostoz, önkol kırığı sonrasında, özellikle cerrahi tespiti takiben gelişebilir.

Ölçütler ve sınıflamalar

Cleary–Omer konjenital radioulnar sinostoz sınıflaması

Cleary–Omer Tip III olgusunda radial baş hipoplazisi bildirilmiştir.

Normalde

Normal proksimal radioulnar eklem, radial baş ile ulnar çentik arasındaki artikülasyondur.

Ayırıcı tanı

Posttravmatik radioulnar sinostoz, önkol kırıkları sonrasında, özellikle cerrahi tespiti takiben radius ile ulna arasında heterotopik kemik oluşumuyla gelişebilir.

Osteokondromlar uzun ve yassı kemiklerin metafizlerinden kaynaklanabilir.

Tuzaklar

• Küçük çocuklarda kıkırdak epifiz ve apofiz yapıları grafide görünmeyebilir; MR dirsek anatomisinin kapsamlı değerlendirilmesini sağlayabilir.
• Edinsel radioulnar sinostozda köprünün konumu ve radyografik olgunlaşması değerlendirilir; travma ve cerrahi öyküsü de göz önünde bulundurulur.

Kendini dene

1. Bir olgu raporunda radial baş hipoplazisiyle birlikte hangi Cleary–Omer tipi bildirilmiştir?

   • Tip III
   • Tip I
   • Tip II
   • Tip IV
   Cevabı göster

   Tip III. S53'te radyografide radial baş hipoplazisiyle Cleary–Omer Tip III bildirilmiştir.

2. Konjenital radioulnar sinostozda hangi hareket kısıtlılığı tanımlanmıştır?

   • Önkol rotasyonunda kısıtlılık
   • Omuz abdüksiyonunda kısıtlılık
   • El bileği fleksiyonunda kısıtlılık
   • Parmak ekstansiyonunda kısıtlılık
   Cevabı göster

   Önkol rotasyonunda kısıtlılık. S39, konjenital radioulnar sinostozu önkol rotasyonunun kısıtlı olmasıyla tanımlar.

İlgili konular

• İzole proksimal radioulnar eklem çıkığı
• Travma sonrası heterotopik ossifikasyon

Kaynaklar

Bu sayfadaki 25 cümle ve 2 quiz sorusu aşağıdaki kaynaklardan alıntılarla otomatik olarak karşılaştırıldı; 16 cümle bu karşılaştırmada düzeltildi (2026-10-09).

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Eğitim amaçlıdır; hasta başında tanı ve tedavi kararının yerine geçmez, tıbbi tavsiye değildir. Metinler yapay zekâ desteğiyle yazıldı ve otomatik bir adımda kaynak alıntılarıyla karşılaştırıldı; bu bir tıbbi doğrulama değildir ve içerik uzman radyolog incelemesinden geçmedi. Klinik kararlarda güncel kılavuzları, kurum protokollerini ve radyoloji raporunu esas alın.