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Journal of Ultrasound in Medicine, Vol 15, Issue 3 213-219, Copyright © 1996 by American Institute of Ultrasound in Medicine
High resolution sonography of the flexor tendons in trigger fingers
G. Serafini, L. E. Derchi, P. Quadri, C. Martinoli, O. Orio, A. Cavallo and N. Gandolfo
Servizio di Radiologia, Ospedale "San Paolo," Savona, Italy.
A sonographic study was conducted to analyze changes of the flexor tendons
in patients with trigger fingers. We evaluated thickness and echotexture of
the flexor tendons of the fingers in 54 patients with 66 symptomatic digits
using 10 and 13 MHz "small parts" transducers; the results were compared
with those observed in 20 normal controls. Images were obtained on the
volar surface of the hand, at the head of metacarpals, and at the base of
first phalanx, where the first annular pulley of the digital canal is
located and where the changes occurring during passive assisted extension
of the fingers were evaluated. Normal tendons were 2.9 to 4.4 mm thick
(mean, 3.71 +/- 0.46) and had fibrillar echotexture. Patients had tendons
ranging from 3.8 to 6.7 mm (mean, 5.41 +/- 0.94); the difference from
controls was highly significant (P < 0.001). A cyst was attached on the
volar surface of the involved tendons in 15 cases. Diffuse thickening of
the synovial sheath was present in 20 tendons, whereas 17 tendons had
irregular internal echotexture. Extension movements caused changes in shape
of both cysts and peritendinous envelopes. In conclusion, sonography seems
able to identify a variety of pathologic changes affecting tendons in these
patients and may help both to explain the pathophysiology of their clinical
situation and guide therapeutic decisions.
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