Injuries to the Collateral Ligaments of the Metacarpophalangeal and Interphalangeal Joints: Sonographic Appearance

Draghi, Ferdinando; Gitto, Salvatore; Bianchi, Stefano

doi:10.1002/jum.14575

Cited by 26 publications

(40 citation statements)

References 80 publications

(94 reference statements)

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“…Static stabilizers of the MCP joints include the ulnar collateral ligament (UCL) and radial collateral ligament (RCL) complexes, the volar plate, the deep transverse metacarpal ligament, the A1 pulley, the sagittal band, and the dorsal capsule reinforced by the extensor hood including oblique fibers from the interosseous and lumbrical muscles. 1,2 Static stabilizers of the PIP joints are the RCL and UCL complexes, the volar plate, the A3 pulley, the central and lateral slips of the extensor tendon, and the distal aponeurotic attachment predominantly made up of the transverse fibers of the interosseous and lumbrical muscles. 1 The collateral ligaments form the borders of the radial and ulnar sides of the metacarpal and interphalangeal joint capsules.…”

Section: Collateral Ligaments Relevant Anatomymentioning

confidence: 99%

“…Each collateral ligament consists of a proper and accessory collateral ligament that thickens and reinforces the joint capsule and acts as a primary stabilizer to varus and valgus stress. 2,3 These ligaments are fan shaped and have an oblique course. The proper collateral ligament of the MCP joints arises from the dorsolateral aspect of the metacarpal head and has an oblique dorsal-to-volar course as it progresses distally to insert along the volar base of the respective proximal phalanx.…”

Section: Collateral Ligaments Relevant Anatomymentioning

confidence: 99%

“…The proper collateral ligament of the MCP joints arises from the dorsolateral aspect of the metacarpal head and has an oblique dorsal-to-volar course as it progresses distally to insert along the volar base of the respective proximal phalanx. 2,5,26 Similarly, the proper collateral ligaments of the proximal and distal interphalangeal joints extend from the lateral aspect of the heads of the proximal and middle phalanges, in a slightly anterior oblique course, to insert onto the volar aspect of the bases of the middle and distal phalanges, respectively. 2 The accessory collateral ligament is contiguous with the proper collateral ligament proximally sharing a similar origin.…”

Section: Collateral Ligaments Relevant Anatomymentioning

confidence: 99%

“…2,5,26 Similarly, the proper collateral ligaments of the proximal and distal interphalangeal joints extend from the lateral aspect of the heads of the proximal and middle phalanges, in a slightly anterior oblique course, to insert onto the volar aspect of the bases of the middle and distal phalanges, respectively. 2 The accessory collateral ligament is contiguous with the proper collateral ligament proximally sharing a similar origin. The accessory collateral ligament extends on the volar aspect of the proper collateral ligament to attach to the thick fibrocartilaginous volar plate on the palmar aspect of the joint.…”

Section: Collateral Ligaments Relevant Anatomymentioning

confidence: 99%

“…The accessory collateral ligament extends on the volar aspect of the proper collateral ligament to attach to the thick fibrocartilaginous volar plate on the palmar aspect of the joint. 1,2,26 The check rein ligaments are proximal extensions of the volar plate that form a reverse U-shape attaching to the accessory collateral ligament (►Fig. 18).…”

Section: Collateral Ligaments Relevant Anatomymentioning

confidence: 99%

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Ultrasound of Normal and Injured Ligaments and Retinacula of the Hand

McCarthy

2020

Semin Musculoskelet Radiol

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Clinical diagnosis of ligament and retinacular injuries of the hand may be challenging. Ultrasound (US) enables detailed high-resolution, dynamic, and real-time evaluation of these structures. This article is a comprehensive review of the intricate anatomy, optimal imaging technique, and normal US appearances of these ligaments and retinacula. The US features, pertinent biomechanics, clinical presentation, and differential diagnosis of injuries affecting the annular pulleys, differentiating from climber's finger; extensor hood including sagittal band and central slip rupture; proximal interphalangeal and metacarpophalangeal collateral ligaments including the Stener lesion and associated volar plate injury; and the anterior oblique or beak ligament of the trapeziometacarpal joint are reviewed. Emphasis is placed on optimal transducer positioning, value of dynamic US, injury severity, surgical indications, and other US findings with important management implications. US facilitates a timely accurate diagnosis of hand ligament and retinacular injury to ensure optimal patient management and minimize the risk of functional impairment of the hand.

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Section: Collateral Ligaments Relevant Anatomymentioning

confidence: 99%

Section: Collateral Ligaments Relevant Anatomymentioning

confidence: 99%

Section: Collateral Ligaments Relevant Anatomymentioning

confidence: 99%

Section: Collateral Ligaments Relevant Anatomymentioning

confidence: 99%

Section: Collateral Ligaments Relevant Anatomymentioning

confidence: 99%

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Ultrasound of Normal and Injured Ligaments and Retinacula of the Hand

McCarthy

2020

Semin Musculoskelet Radiol

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Ultrasound Evaluation of Sesamoid Fractures of the Hand: Retrospective Report of 13 Patients

Bianchi¹,

Becciolini²

2018

J of Ultrasound Medicine

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S esamoid bones are small ossicles located where tendons pass over a joint. Their name is related to their appearance, resembling the oval seeds of the plant "Sesamum indicum." 1 The biomechanical role of sesamoids is not completely understood, but it seems that they reduce friction, protect tendons, and give support to joints. 2 Usually, there are 5 sesamoid bones in the hand, mainly localized at the palmar surface of metacarpophalangeal (MCP) joint. In almost 100% of the population there are 2 sesamoids at the MCP joint of the thumb. 3 Less common sesamoid bones are located at the interphalangeal joint of the thumb (53%), at the MCP joint of the index finger (43.4%), and at the MCP joint of the small finger (66.7%). 2 Exceptionally, sesamoid bones may be found in other MCP joints and interphalangeal joints. 4 Bipartite sesamoid bones were found in 0.6% to 6% of cadaveric hands. 5 The radial sesamoid bone of the thumb MCP joint is embedded within the adductor pollicis tendon, whereas the ulnar one lies inside the flexor pollicis brevis tendon. 6 The two sesamoid bones are connected to the palmar plate and play an important role in joint stability, limiting hyperextension. 7 The index sesamoid bone is frequently located on the radial aspect of the MCP joint, whereas the little finger sesamoid bone is on the ulnar side of the joint. 2 Disorders of hand sesamoid bones are mainly posttraumatic and can be seen in joint sprains, at the MCP joint of the thumb, or in direct trauma such as during falls on MCP joints of other fingers. Because of the sesamoid bones' small size and superposition of the ossicles with the adjacent bones, sesamoid bone fractures are difficult to detect on standard radiographs. Ultrasound (US) can show radiographically occult fractures. 7-10 We present a retrospective review of 13 patients with fractures of sesamoid bones of the hand detected by US.We present a review of 13 patients in whom ultrasound showed a traumatic fracture of a sesamoid of the hand. Clinically, no patients were suspected of having a sesamoid fracture. Radiographs were available in 9 patients: possible fracture of a sesamoid was reported in 1. Ultrasound showed an irregular shape, focal interruption of the bone, and avulsed fragments. In 4 patients, the diagnosis was confirmed by computed tomography. One patient with an associated ligament tear underwent surgery. The remaining patients were treated conservatively with positive outcomes at follow-up. Evaluation of the sesamoids should be part of an ultrasound examination of the hands in posttraumatic patients.

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Ultrasound Features of Trigger Finger: Review of the Literature

Bianchi¹,

Gitto

Draghi

2019

J of Ultrasound Medicine

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Trigger finger is a common pathologic condition of the digital pulleys and flexor tendons in the hand. The key clinical finding is a transient blockage of the digit when it is flexed with subsequent painful snapping when it is extended. Imaging is a helpful guide for establishing the severity of the disease, identifying the underlying cause, and deciding the appropriate management. This narrative review aims to recall the anatomic and pathologic bases and describe the ultrasound features of trigger finger, also including common ultrasound findings and complications after therapy. Ultrasound enables an accurate static and dynamic evaluation of trigger finger as well as a comparison with the adjacent normal digits and thus should be considered the radiologic modality of first choice for its diagnosis.

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Injuries to the Collateral Ligaments of the Metacarpophalangeal and Interphalangeal Joints: Sonographic Appearance

Cited by 26 publications

References 80 publications

Ultrasound of Normal and Injured Ligaments and Retinacula of the Hand

Ultrasound of Normal and Injured Ligaments and Retinacula of the Hand

Ultrasound Evaluation of Sesamoid Fractures of the Hand: Retrospective Report of 13 Patients

Ultrasound Features of Trigger Finger: Review of the Literature

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