Abstract:
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Purpose: To analyze the sonographic findings of trigger fingers diagnosed clinically by comparison with those of normal fingers, with emphasis of the findings of annular pulleys, which were not demonstrated previously.
Methods and Materials: Forty-four fingers of 38 patients with trigger fingers diagnosed clinically and 31 asymptomatic contralateral fingers from 29 patients as normal controls were included in this study. The mean age of patients with trigger fingers was 39 years (age range, 7-74 years; female 32, male 6), and that of normal control group was 49 years (age range, 7-74 years; female 24, male 5). Longitudinal and axial images of flexor digitorum tendons (FDTs) and adjacent soft tissue were obtained with careful examination of annular pulleys including A1 pulley. Two radiologists analyzed the sonographic findings such as visualization and thickness of annular pulleys, thickness and echo pattern of FDTs, distension of tendon sheath, and presence of ganglion, retrospectively. Statistical significances for the difference of thickness of annular pulleys and FDTs between the patient and normal control groups were determined with independent sample t-test. Probability value less than .05 was considered statistically significant.
Results: Twenty-six of 44 fingers (59%) showed thickening of annular pulleys (A1 in 20, A3 in 6). The thickness of annular pulleys of control and patient groups were 0.27 ± 0.40 mm and 0.77 ± 0.85 mm, respectively. The thickness of FDTs of control and patient groups were 3.35 ±0.77 mm and 3.6 ± 0.9 mm, respectively. The annular pulleys were significantly thickened in patient group than in control group (p<0.05), but the FDTs were not. The echo pattern of FDTs was normal in 38 fingers (86%), only six fingers (14%) showed decreased echo and loss of normal fibrillary pattern within the tendons. Three fingers showed distension of tendon sheath and one finger showed ganglion attached to the tendon sheath.
Conclusion: Sonography demonstrated the presence or absence and the severity of thickening of annular pulleys in patients with trigger fingers. The change of FDTs and associated other findings were also revealed.
Chung MD, H,
Ultrasonography of the Trigger Fingers: On the Emphasis of the Findings of Annular Pulley. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3103903.html
