Thickness of extensor tendons at the proximal intersection: sonographic measurements in asymptomatic volunteers

The role of ultrasonography in diagnosing acute closed volar plate injury of proximal interphalangeal joint

BACKGROUND

Acute closed volar plate injury of the proximal interphalangeal joint (PIP) is a common hand injury. In the past, there were few objective evaluation imaging methods for the degree of volar plate injury. The purpose of this study was to investigate the role of high frequency ultrasonography in diagnosing volar plate injury, and to explore whether ultrasound can provide a beneficial guidance to clinical decision-making and appropriate treatment adopting through accurate US classification of volar plate injury.

METHODS

From May 2019 to may 2022, 41 patients diagnosed with volar plate injury were included in this study. All patients underwent ultrasonography and X-ray examinations. The sonographic features were analyzed. A new kind of classification of volar plate injury based on ultrasonography findings was described.

RESULTS

Either an injury of volar plate or an avulsion fracture of middle phalangeal base was identified clearly on ultrasonography, according to which volar plate injury could be divided into three types: A, B and C. Type A, avulsion fracture of the middle phalangeal base without volar plate rupture; Type B, full thickness tear of the volar plate without avulsion fracture; Type C, partial thickness tear of the volar plate. The average thickness of the three types of injured volar plate measured by ultrasound was 0.33 ± 0.05 cm, and the average thickness of the volar plate at the same site of the corresponding finger on the contralateral side was 0.22 ± 0.03 cm. There was significant difference between the two group (t = 11.823, p = 1.2476 *10^(-14)).

CONCLUSIONS

High frequency ultrasonography could be a reliable, accurate, convenient and non-radioactive diagnostic imaging technique in the evaluation of acute closed volar plate injury of PIP. And ultrasound could provide a beneficial guidance to clinical decision-making and appropriate treatment adopting through accurate US classification.

Sonography of Non-neoplastic Disorders of the Hand and Wrist Tendons

Tendon disorders commonly cause hand and wrist disability and curtail the performance of work-related duties or routine tasks. Imaging is often needed for diagnosis, but it requires knowledge of the complex anatomic structures of the tendons of the hand and wrist as well as familiarity with related disorders. This review article aims to provide medical professionals with guidelines for the sonographic assessment of the tendons of hand and wrist and related disorders. Sonographic features of tendon disorders affecting the hand and wrist are described here, specifically: infectious tenosynovitis; tendon rupture or tearing; stenosing forms of tenosynovitis such as De Quervain disease and trigger finger; intersection syndrome; insertional tendinopathy; several forms of tendinous instability such as extensor carpi ulnaris instability, climber finger, and boxer knuckle; and tendinopathy in inflammatory rheumatic diseases. Postsurgical evaluation of the hand and wrist tendons is also discussed, including the healthy and pathologic appearances of operated tendons as well as impingement from orthopedic hardware. In conclusion, sonography is effective in assessing the tendons of the hand and wrist and related disorders and represents a valuable tool for diagnosis.

The Role of High Frequency Ultrasonography in Diagnosis of Acute Closed Mallet Finger Injury

To evaluate the role of high frequency ultrasonography in diagnosis of acute closed mallet finger injury. 36 patients diagnosed with mallet finger were included in this study. All patients underwent ultrasonography, magnetic resonance imaging(MRI) and X-ray examinations. A new kind of classification of acute mallet finger injury based on ultrasonography findings was described. The difference in terms of extensor tendon injury and bony fragment identification ability among the three types of examinations were described respectively. Either an injury of extensor digital tendon or an avulsion fracture of distal phalangeal base was identified clearly on ultrasonography. Among the 36 cases, avulsion fracture of the distal phalangeal base was found without extensor tendon rupture in Type A, complete rupture of the extensor tendon was found without avulsion fracture in Type B, and contusion of the extensor tendon was found in Type C. Compared with X-ray, ultrasonography and MRI could show the extensor tendon injury clearly. While compared with MRI, ultrasonography and X-ray was more sensitive in showing bony fragment. High frequency ultrasonography could be an accurate, reliable, and non-invasive diagnostic imaging method in diagnosis of acute close mallet finger injury.