Bowstring injury of the flexor tendon pulley system: MR imaging.

Parellada, J. Antoni; Balkissoon, Avinash R. A.; Hayes, Curtis W.; Conway, William F.

doi:10.2214/ajr.167.2.8686601

Cited by 48 publications

(25 citation statements)

References 2 publications

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“…However, if the torn pulleys are difficult to detect by imaging, the diagnosis of complete pulley rupture can be made indirectly by demonstrating palmar bowstringing of the flexor tendons [13,15e18]. US, MRI [11,19,20] and CT can be used to evaluate digital pulley ruptures.…”

Section: Acute Tearsmentioning

confidence: 99%

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Ultrasound of the digital flexor system: Normal and pathological findings

Bianchi

Martinoli

Gautard

et al. 2007

Journal of Ultrasound

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Recent improvements in ultrasound (US) software and hardware have markedly increased the role of this imaging modality in the evaluation of the musculoskeletal system. US is currently one of the main imaging tools used to diagnose and assess most tendon, muscle, and ligament disorders. Compared with magnetic resonance imaging, US is much less expensive; it has no contraindications and is also widely available. Diseases affecting the digital flexor system (DFS) require early diagnosis if treatment is expected to limit functional impairment of the hand. US scans performed with high-resolution, broad-band transducers allows superb visualization of the flexor tendons of the hand and the annular digital pulleys. In addition, dynamic US can be used to assess movement of the tendon within the pulleys during passive or active joint movements. This article examines the anatomy and US appearance of the normal DFS and reviews the US findings associated with the most common disorders affecting it.Sommario I recenti miglioramenti nell'hardware e software delle apparecchiature ecografiche hanno aumentato in maniera importante il ruolo dell'ecografia nella valutazione del sistema muscolo-scheletrico. Attualmente l'ecografia rappresenta un'importante metodica d'imaging per la valutazione delle malattie dei tendini, muscoli e legamenti. L'ecografia non è invasiva ed è meno cara e più disponibile della risonanza magnetica.Le malattie del sistema flessorio delle dita richiedono una diagnosi precoce al fine di instaurare un trattamento corretto capace di prevenire la limitazione funzionale della mano.Se realizzata con apparecchiature ad alta risoluzione operanti con trasduttori a larga banda, l'ecografia consente un'eccellente valutazione dei tendini flessori della mano e delle pulegge anulari. L'ecografia consente, inoltre, un accurato esame dinamico dello scorrimento dei tendini nei tunnel osteofibrosi digitali durante i movimenti di flesso-estensione delle dita.In quest'articolo presentiamo l'anatomia normale del sistema flessorio delle dita della mano e l'anatomia ecografica normale, seguite da una presentazione dell'aspetto ecografico nelle più comuni malattie interessanti i tendini flessori della mano. ª

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Section: Acute Tearsmentioning

confidence: 99%

“…Although MR and CT can be used to diagnose DAP tears [11,19,20], US is less expensive, and non-traumatic, and it allows dynamic evaluation. One of the advantages of US with respect to CT is that it can reveal a synovial sheath effusion.…”

Section: Acute Tearsmentioning

confidence: 99%

Ultrasound of the digital flexor system: Normal and pathological findings

Bianchi

Martinoli

Gautard

et al. 2007

Journal of Ultrasound

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“…There is no communication between this sheath and the joint spaces. In addition to this synovial sheath, the tendon is covered by two types of fibrous reinforcements, termed the annular and cruciform pulleys [14][15][16]. The cruciform reinforcements are less important and are difficult to recognize on anatomic dissection.…”

Section: Fingermentioning

confidence: 99%

“…In d, the flexor profundus (arrows) continues and inserts on the base of the distal phalanx 3 annular pulleys is to keep the tendon in close contact with the bone during flexion of the finger. Indeed, when these pulleys are torn, the result is a bowstring appearance, with the flexor tendon at an increased distance from the bone [16]. At the level of the joints, the flexor tendons are at a slight distance from the bone.…”

Section: Fingermentioning

confidence: 99%

Sonography of the finger flexor and extensor system at the hand and wrist level: findings in volunteers and anatomical correlation in cadavers

Maeseneer

Marcelis

Jager³

et al. 2007

Eur Radiol

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We present a review of sonography of the flexor and extensor system of the hand and wrist in volunteers and cadavers. CT tenography also was performed in cadaveric specimens. Anatomical structures of the extensor system that were assessed with sonography included the extensor tendons and insertions, retinaculum, and dorsal hood. On the flexor side, the variable relationship between the flexor superficialis and profundus could be appreciated. Volar plates, tendon insertions, and annular pulleys could also be investigated. Sonography can show details of the finger flexor and extensor system.

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“…As the patient was in considerable discomfort, a fast scan using TSE (Turbo spin echo) was performed. This demonstrated that the flexor tendons to all three fingers were intact; however there was an abnormally large gap between the tendons and the proximal interphalangeal joint on the T1 (TR-600/TE-15) sequence ( 4 Unfortunately, due to discomfort the patient could only tolerate sagittal examinations and axial sections could not be performed. Reconstructive surgery was offered to the patient which she declined.…”

Section: Case Reportmentioning

confidence: 99%