Introduction

Ultrasound of the hand and wrist is one of the fundamental methods in PMR, orthopedics, and sports medicine for examining soft tissues and peripheral nerves. It enables detailed visualization of the flexor and extensor tendon apparatus, synovial sheaths, retinacula, and peripheral nerves, particularly the n. medianus in the carpal tunnel and the n. ulnaris in Guyon's canal. The examination is particularly beneficial for wrist and hand pain, swelling, tendon snapping, suspected tenosynovitis, ganglion, compressive neuropathy, or partial tendon rupture. The foundation is systematic examination in both transverse and longitudinal planes with orientation according to the distal radius and ulna, carpal bones, and extensor compartments, always with active probe manipulation to limit anisotropy. An important component is also dynamic examination, which allows assessment of tendon instability, pathology in the carpal tunnel area, and the relationship of findings to movement. Ultrasound simultaneously enables differentiation of effusion, synovitis, tenosynovitis, nerve compression, and minor partial tendon lesions while immediately correlating findings with clinical complaints.