High-Resolution 3-T MRI of the Fingers: Review of Anatomy and Common Tendon and Ligament Injuries

Gupta, Pushpender; Lenchik, Leon; Wuertzer, Scott; Pacholke, David A.

doi:10.2214/ajr.14.12776

Cited by 35 publications

(34 citation statements)

References 44 publications

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“…Additionally, tendons build so-called functional entheses with associated ligamentous structures, such as flexor tendon pulleys [11]. These pulleys have a fibrocartilaginous component and discontinuously wrap around the flexor tendons preventing their bowstringing during flexion [12]. Recent studies have shown that inflammation and thickening of flexor tendon pulleys are potentially due to mechanical stress ("deep Koebner response") and may lead to the initial development of flexor tenosynovitis and dactylitis, that are major features of PsA [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

et al. 2020

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Background: To evaluate the value of 3 Tesla (T) magnetic resonance imaging (MRI) changes of flexor tendon pulleys for the differentiation of psoriatic (PsA) and rheumatoid arthritis (RA), using a novel 16-channel highresolution hand coil. Methods: Seventeen patients with active PsA, 20 patients with active RA, and 16 healthy controls (HC) underwent high-resolution 3 T MRI using the dedicated 16-channel hand coil. Images were analyzed by three independent readers for the degree of inflammatory changes, thickness of flexor tendon pulleys, and comparison to the outcome measures for RA clinical trials (OMERACT) PsA MRI score (PsAMRIS) and to its sub-scores. For correlation analyses, Spearman rho correlation was calculated. Results: Flexor tendon pulleys were thicker in PsA than in RA patients (mean difference 0.16 mm, p < 0.001) and HC (mean difference 0.2 mm, p < 0.001) and showed a higher degree of associated inflammatory changes (mean difference from RA 4.7, p = 0.048; mean difference from HC 14.65, p < 0.001). Additionally, there was a strong correlation of accessory pulley inflammation and PsAMRIS and its acute-inflammatory sub-scores, flexor tenosynovitis, synovitis, and periarticular inflammation (for the second digit synovitis ρ = 0.72, flexor tenosynovitis ρ = 0.7, overall PsAMRIS ρ = 0.72, p < 0.01). Similar robust correlations were evident in digits 3-5. Weaker correlations were evident in RA (synovitis ρ = 0.49, flexor tenosynovitis ρ = 0.49, periarticular inflammation ρ = 0.4). Conclusion: The assessment of MRI changes of flexor tendon pulleys is potentially beneficial for disease detection in PsA, as well as for its distinction from RA and HC.

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Section: Introductionmentioning

confidence: 99%

High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

et al. 2020

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“…When imaging the thumbs, coronal and sagittal views should be tilted 90° to sesamoids at the level of the metacarpophalangeal joint (Figure 3) [13]. It is always important to include adjacent fingers within the field of view of the image for comparison [14]. Three-Tesla MRIs are preferred due to the high resolution and detail provided for these small anatomical regions.…”

Section: Hand/wrist 41 Mri Protocolmentioning

confidence: 99%

Imaging of Tendons

Torres-Ayala¹,

Bravo-Martínez²,

Marrero-González³

et al. 2019

Tendons

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Magnetic resonance imaging (MRI) and ultrasound (US) are useful radiologic modalities that allow adequate evaluation of tendon anatomy and integrity. Each modality contains unique advantages as diagnostic tools, allowing detection of tendon injuries and pathology. This chapter focuses on the key imaging features of tendons in both ultrasound and magnetic resonance, with emphasis on the major joints such as the shoulder, elbow, hand/wrist, hip, knee and foot/ankle joints. Each section provides a review of standard magnetic resonance imaging protocols and ultrasound technique, along with a discussion of the radiologic appearance of the most common tendon pathology affecting each joint.

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“…These measurements help plan derotational osteotomy and evaluate therapy results. 47 Magnetic Resonance Imaging MRI is extremely valuable in evaluating traumatic soft tissue injuries of the hand and fingers 48 and is able to diagnose accurately the extent of tendon, ligament, and other soft tissue injury. 46 Tendons, ligaments, and volar plates have a homogeneous low signal on T1-weighted, T2-weighted, and PD sequences.…”

Section: Computed Tomographymentioning

confidence: 99%

Emergency and Trauma of Hand and Wrist

Kraan

Walstra

Teunis

et al. 2017

Semin Musculoskelet Radiol

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Traumatic injuries of the hand and wrist are common in daily practice. Several challenges arise in the process of diagnosis and guiding the clinician. Knowledge of the complex finger, hand, and wrist anatomy is essential to understand the broad array of traumatic injuries extending from (stress)fractures to ligament, tendon, and neurovascular injuries. This article provides an overview of the different imaging techniques used in the evaluation of the hand and wrist. Emphasis is placed on the most common traumatic injuries of the hand, wrist, and fingers, and the imaging modality of choice in evaluating these injuries.

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High-Resolution 3-T MRI of the Fingers: Review of Anatomy and Common Tendon and Ligament Injuries

Cited by 35 publications

References 44 publications

High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

High-resolution MRI of flexor tendon pulleys using a 16-channel hand coil: disease detection and differentiation of psoriatic and rheumatoid arthritis

Imaging of Tendons

Emergency and Trauma of Hand and Wrist

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