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© 2008 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 27:1407-1413 • 0278-4297

Sonographic Appearance of Trigger Fingers

Henri Guerini, MD, Eric Pessis, MD, Nicolas Theumann, MD, Janine-Sophie Le Quintrec, MD, Raphaël Campagna, MD, PhD, Alain Chevrot, MD, PhD, Antoine Feydy, MD and Jean-Luc Drapé, MD

Departments of Radiology B (H.G., E.P., R.C., A.C., A.F., J.-L.D.) and Rheumatology (J.-S.L.Q.), Hôpital Cochin, Assistance Publique–Hôpitaux de Paris, Université Paris Descartes, Paris, France; and Department of Radiology, Centre Hospitalier Universitaire Vaudois Lausanne, Lausanne, Switzerland (N.T.).

Address correspondence to Henri Guerini, MD, Department of Radiology B, Hôpital Cochin, Assistance Publique–Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, France. E-mail: henri.guerini{at}cch.aphp.fr

Objective. The purpose of this study was to describe the sonographic appearance of the first annular (A1) pulley–flexor tendon complex in patients with trigger fingers. Methods. Thirty-three trigger fingers in 33 patients were examined with a 7- to 15-MHz probe. A control group consisted of 20 patients without trigger fingers. The study included systematic measurement of the thickness of the A1 pulley and a power Doppler assessment of the pulleys, tendons, and tendon sheaths. Results. Thickening and hypoechogenicity of the A1 pulley were found in all patients with trigger fingers. Measurements of A1 pulley thickness were significantly different (P < .0001) between the groups without trigger fingers (mean, 0.5 mm; range, 0.4–0.6 mm) and with trigger fingers (mean, 1.8 mm; range, 1.1–2.9 mm). Hypervascularization of the A1 pulley on power Doppler imaging was found in 91% of the trigger fingers but was never found in the healthy control group. Flexor tendinosis was found in 48% of the trigger fingers; tenosynovitis was found in 55%; and both were found in 39%. In the control group, tenosynovitis and tendinosis were not found. Conclusions. Thickening and hyper-vascularization of the A1 pulley are the hallmarks of trigger fingers on sonography. Other frequently observed features include distal flexor tendinosis and tenosynovitis.

Key Words: finger • power Doppler sonography • sonography

Abbreviations: A1, first annular • MCP, metacarpophalangeal • P1, proximal phalanx

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Copyright © 2008 by the American Institute of Ultrasound in Medicine.