Lumbrical muscle tear: clinical presentation, imaging findings and outcome

Lutter, Christoph; Schweizer, Andreas; Schöffl, Volker; Römer, Frank; Bayer, Thomas A.

doi:10.1177/1753193418765716

Cited by 18 publications

(4 citation statements)

References 13 publications

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“…Due to its bipennate connection to FDP tendons III and IV, the third lumbrical muscle is at risk of rupture if affected by increased transverse tension, for example in free climbers [61,62]. The muscle rupture can be visualized on high-resolution T2-weighted images by means of muscle edema and fiber discontinuity.…”

Section: Injury Of the Third Lumbrical Musclementioning

confidence: 99%

Tendons and Tendon Sheaths of the Hand – An Update on MRI

Schmitt

Hesse

Grunz

2022

Rofo

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Background The tendons of the hand run in close proximity to each other and within retinacular tunnels adjacent to articular joints, while forming intersections in characteristic locations. The enclosing tendon sheaths are often sites of systemic or infectious inflammation. Method This review article outlines the different entities of tendon and tendon sheath pathology and their manifestation in the hands. Diagnostic findings in tendon and tendon sheath disorders are illustrated using MRI imaging and discussed in context with the current literature. Results and Conclusion Overuse may cause stenosis in the fibrous outer layer of the retinacula and the A1 annular ligaments as well as tendinosis. In contrast, proliferative tenosynovitis is a disease of the synovial inner layer of the tendon sheath with tendon infiltration and tendinitis. Pyogenic tenosynovitis favors the flexor compartments. Because of the narrow spaces in the hand, a high-resolution MRI technique must be used. Key Points: Citation Format

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Section: Injury Of the Third Lumbrical Musclementioning

confidence: 99%

Tendons and Tendon Sheaths of the Hand – An Update on MRI

Schmitt

Hesse

Grunz

2022

Rofo

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“…This explains why strain injuries occur most often to the third and fourth lumbricals, which are commonly bipennate. Rest and immobilization have been suggested to be sufficient to treat lumbrical sprain ( 17 ) . Atrophic changes may be found affecting the first and second lumbricals in median neuropathies and in the third and fourth lumbricals in ulnar neuropathies ( 18 , 19 ) .…”

Section: Lumbricalsmentioning

confidence: 99%

Ultrasound of the palmar aspect of the hand: normal anatomy and clinical applications of intrinsic muscles imaging

Picasso,

Zaottini,

Pistoia

et al. 2023

J Ultrason

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Intrinsic hand muscles play a fundamental role in tuning the fine motricity of the hand and may be affected by several pathologic conditions, including traumatic injuries, atrophic changes induced by denervation, and space-occupying masses. Modern hand surgery techniques allow to target several hand muscle pathologies and, as a direct consequence, requests for hand imaging now carry increasingly complex diagnostic questions. The progressive refinement of ultrasound technology and the current availability of high and ultra-high frequency linear transducers that allow the investigation of intrinsic hand muscles and tendons with incomparable resolution have made this modality an essential tool for the evaluation of pathological processes involving these tiny structures. Indeed, intrinsic hand muscles lie in a superficial position and are amenable to investigation by means of transducers with frequency bands superior to 20 MHz, offering clear advantages in terms of resolution and costs compared to magnetic resonance imaging. In addition, ultrasound allows to perform dynamic maneuvers that can critically enhance its diagnostic power, by examining the questioned structure during stress tests that simulate the conditions eliciting clinical symptoms. The present article aims to review the anatomy, the ultrasound scanning technique, and the clinical application of thenar, hypothenar, lumbricals and interossei muscles imaging, also showing some examples of pathology involving these structures.

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“…Lutter et al (18) suggested 4 wk of functional therapy for a grade 1 injury. A grade 2 injury should be treated with 8 wk of therapy and the addition of “buddy taping” of the affected digit for pain reduction.…”

Section: Finger and Wristmentioning

confidence: 99%

“…A grading system was proposed in a study by Lutter et al (18). A grade 1 injury consists of microtrauma without imaging findings.…”

Section: Finger and Wristmentioning

confidence: 99%

A Guide to Indoor Rock Climbing Injuries

Leung¹

2023

Curr Sports Med Rep

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Rock climbing is an increasingly popular indoor sport with a sizable risk of overuse injuries. Yet, many medical practitioners have little familiarity with evaluating and treating climbing injuries because of the terminology, biomechanical demands, mechanisms of injury, and return to sport counseling needed, unique to the sport. This review seeks to educate practitioners on these aspects. Upper extremity injuries occur more frequently than lower extremity injuries, with finger injuries being most prevalent. Pulley injuries, consisting of rupture of the A2 or A4 annular pulleys are the most common type of injury. Other finger injuries include tenosynovitis of the flexor tendons, as well as lumbrical muscle tears. Elbow injuries occur frequently, with medial epicondylopathy being most common. Brachialis injuries are seldom seen outside of climbing. Lower-extremity injuries are typically more acute in nature, including ankle injuries from falls and knee injuries from strenuous climbing moves.Rock climbing is an increasingly popular sport, especially after its inclusion in the 2020 Olympics. In 2021, 53 new climbing gyms opened in the United States despite the COVID-19 pandemic, totaling 591, around four times the number of gyms that existed in 2000 (1). Now, there are almost twice as many indoor climbers as those who climb outdoors (2). Although generally considered safe, a literature review showed that injuries are still common, with an incidence of between 1.52 and 4.24 per 1000 hours of participation (3). Even with an increasing amount of research on this subject, there are still few publications reviewing climbing injuries with the focus of informing medical practitioners who may encounter them.

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Lumbrical muscle tear: clinical presentation, imaging findings and outcome

Abstract: IV.

Cited by 18 publications

References 13 publications

Tendons and Tendon Sheaths of the Hand – An Update on MRI

Tendons and Tendon Sheaths of the Hand – An Update on MRI

Ultrasound of the palmar aspect of the hand: normal anatomy and clinical applications of intrinsic muscles imaging

A Guide to Indoor Rock Climbing Injuries

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