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Musculoskeletal Imaging

E2870. Application of Ultrasound to Evaluate Finger Tendon Pathologies

Chalian M,  Nacey N. University of Virginia, Charlottesville, VA

Address correspondence to M. Chalian (m.chalian@gmail.com)

Background Information: Lack of radiation, high spatial resolution, low cost, widespread availability, capability for dynamic imaging, and the ability to directly correlate imaging findings with patient symptoms in real time have made applications of ultrasound (US) grow dramatically over the past decade. Given the superficial nature of the finger tendons, US is well suited to evaluate these delicate structures and can yield high resolution images. However, detailed knowledge of the anatomy, accurate scanning technique, and familiarity with common imaging manifestations of various finger tendon pathologies are crucial for an accurate diagnosis.

Educational Goals/Teaching Points: Participants will be familiarized with finger US techniques, review the US appearance of normal finger structures, and be familiarized with common finger pathologies and their US appearances.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: The key issues to be discussed in this exhibit will be a review of normal finger anatomy, finger ultrasound scanning technique, and the most common normal variants and pitfalls. We will also address the most common finger pathologies by providing representative images. They include the most common finger flexor and extensor tendon pathologies (tenosynovitis, complete tendon rupture, partial tendon teat, closed tendon avulsion, pseudotendon formation, and postoperative evaluation of tendons) as well as sagittal band injuries and flexor pulley mechanism pathologies such as trigger finger. Common finger mass lesions will be addressed as well.

Conclusion: The capacity for generating high resolution images with dynamic assessment make US an excellent choice for evaluating finger tendon pathologies, at much lower cost than is possible with MRI. However, many radiologists may not feel comfortable with the necessary scanning techniques and the complex anatomy of this region. Familiarity of radiologists with the US appearance of normal finger anatomy and common pathologies is crucial for appropriate patient care.