Matthew Ryan Hammer MD, Presenter: Nothing to Disclose

Deepa R. Pai MD, Abstract Co-Author: Nothing to Disclose

Michael A. DiPietro MD, Abstract Co-Author: Nothing to Disclose

Jon A. Jacobson MD, Abstract Co-Author: Consultant, BioClinica, Inc Royalties, Reed Elsevier Equipment support, Terumo Corporation

Michelle S Caird MD, Abstract Co-Author: Nothing to Disclose

Clifford L Craig MD, Abstract Co-Author: Nothing to Disclose

To review the ultrasound appearance of pediatric trigger thumbs and discuss emerging clinical applications.

An overview of the clinical presentation of pediatric trigger thumb is provided. Pertinent anatomy of the thumb, including the relationship of the flexor pollicis longus (FPL) tendon with the A1 pulley, is reviewed. Ultrasound images of normal and abnormal children’s thumbs with important measurements, including the dorsal-volar thickness and cross sectional area of the FPL at its thickest portion and at the A1 pulley as well as the real-time evaluation of the gliding motion of the FPL are reviewed. There is a review of the literature and discussion of how ultrasound results may influence the surgical management of this condition.

Trigger thumb presents in young children with fixed contracture of the interphalangeal joint or snapping at the joint with passive motion. The etiology of the disorder remains unclear. Treatment is controversial as symptoms sometimes resolve with conservative measures, including splinting, while other children require surgical release. After reviewing this exhibit, radiologists should be aware of the imaging appearance of pediatric trigger thumb and could consider discussing how imaging may be useful in determining the management of these patients with their pediatric orthopedic colleagues.

Hammer, M, Pai, D, DiPietro, M, Jacobson, J, Caird, M, Craig, C, Ultrasound Evaluation of Pediatric Trigger Thumb.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12033580.html