Imaging Finger Joint Instability with Ultrasound

Abstract

Closed injuries affecting the metacarpophalangeal and interphalangeal joints and their stabilizers in the thumb and fingers occur very commonly in athletes, possibly leading to finger joint instability and long-standing or permanent disability. This article reviews the spectrum of joint injuries of the thumb and fingers that are common in the athletic population with a main focus on the ultrasound features of collateral ligament tears, palmar plate injuries, and thumb sesamoid fractures. A thorough understanding of the complex anatomy, mechanism of injury, soft tissue abnormalities, and imaging findings is critical in the diagnostic work-up of closed finger joint trauma and may help improve outcomes.

Ultrasound-detected lateral band snapping syndrome in proximal interphalangeal joint of small finger—A rare case report

“…On the other hand, the ganglion cyst of tendon sheath may display an anechoic mass lesion. When used for proper indications, ultrasonography has a definite role in the diagnosis of injuries of the ligaments on small finger joints [6].…”

Ultrasound versus MRI in the evaluation of the thumb metacarpophalangeal joint

“…Ultrasound offers real-time dynamic imaging with even greater spatial resolution, which is well-suited for the fine superficial structures of the digits (1) . The small footprint of the "hockey stick" probe allows optimal anatomic positioning when assessing structures like the UCL.…”

“…Secured by the volar ligaments and embedded in the volar plate, the thumb sesamoids serve to decrease friction, maximize forces, and protect the adjacent tendons at the MCP joint (14) . The AdP tendon inserts on the ulnar sesamoid, and the FPB tendon inserts onto the radial sesamoid (1,2) . Additionally, the first annular (A1) pulley and accessory collateral ligaments attach to the sesamoid bones (2) .…”

“…Humans depend on the unique and complex anatomy of the opposable thumb, which affords a wide range of motion and allows fine manual dexterity. Conditions limiting the use of the thumb lead to profound functional impairments and reduced quality of life (1,2) . While the thumb carpometacarpal joint is commonly affected by joint degeneration due to its inherent instability, the thumb metacarpophalangeal (MCP) joint is most predisposed to injury (2) .…”

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

“…In the early stage, volar plate injury presents with instability of joint. If combined with collateral ligament injury, instability of joint flexion and lateral deviation will both occur, which may become an obstacle to the reduction of joint dislocation [ 1 – 3 ]. Although clinicians can make the diagnosis of acute closed volar plate injury according to the symptoms and signs, there are few objective evaluation imaging methods for the degree of acute closed volar plate injury [ 4 – 6 ].…”