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© 2004 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 23:331-337 • 0278-4297

Value of Transducer Positions in the Measurement of Finger Flexor Tendon Thickness by Sonography

Andrea Klauser, MD, Karl-Heinz Stadlbauer, MD, Ferdinand Frauscher, MD, Manfred Herold, MD, Guenther Klima, MD, Michael Schirmer, MD and Dieter zur Nedden, MD

Department of Radiology II (A.K., K.-H.S. F.F., D.z.N.), Department of Internal Medicine, Division of General Internal Medicine (M.H., M.S.), and Institute of Anatomy and Histology (G.K.), University Hospital Innsbruck, Innsbruck, Austria.

Address correspondence and reprint requests to Andrea Klauser, MD, Department of Radiology II, University Hospital Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. E-mail: andrea.klauser{at}uibk.ac.at.

Objective. To assess the value of 2 transducer positions for measurement of finger flexor tendon thickness by sonography. Methods. Flexor tendon thickness of the third finger was measured sonographically by 2 independent investigators in 20 healthy volunteers (n = 40 fingers) and in 4 cadaveric specimens (n = 4 fingers). Flexor tendon thickness was measured at histologic examination in the cadaveric specimens. We defined the area of the A1 annular pulley as position I and the area of the A2 annular pulley as position II. Sonographic measurements were performed in transverse (dorsovolar and radioulnar) and longitudinal planes. Interobserver and intraobserver variabilities were evaluated by each investigator performing 3 measurements at each position. Results. In position I, volunteers had flexor tendon thickness of 2.7 to 4.0 mm (mean ± SD, 3.28 ± 0.26 mm) longitudinally; transversally the thickness was 2.5 to 4.0 mm (mean, 3.34 ± 0.29 mm) dorsovolar and 5.5 to 8.9 mm (mean, 7.34 ± 0.71) radioulnar in position I. Position II revealed thickness of 3.2 to 4.2 mm (mean, 3.6 ± 0.23 mm) longitudinally; transversally the thickness was 2.7 to 4.1 mm (mean, 3.4 ± 0.27) dorsovolar and 4.3 to 6.8 mm (mean, 5.27 ± 0.65) radioulnar. Interobserver and intraobserver variability for position I was better than for position II (P < .01 versus P < .05). Sonographic findings correlated excellently with histologic findings (r2 = 0.94). Conclusions. Standardized transducer positions for sonographic measurements of finger flexor tendon thickness showed good interobserver and intraobserver variability. Position I was found to be more reliable than position II.

Key Words: finger, tendon • sonography • standardization, observer variation

Abbreviations: FFT, finger flexor tendon • MCP, metacarpophalangeal

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Copyright © 2004 by the American Institute of Ultrasound in Medicine.