Sonography findings in tears of the extensor pollicis longus tendon and correlation with CT, MRI and surgical findings

Santiago, Fernando Ruíz; Plazas, Pilar Garófano; Fernández, Juan Miguel Tristán

doi:10.1016/j.ejrad.2007.05.007

Cited by 25 publications

(20 citation statements)

References 8 publications

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“…Although volar plates are usually well tolerated, they can lead to impingement on the extensor tendons when the fixation screws are too long and extend beyond the dorsal cortex of the radius. This form of impingement has been reported in several articles in the orthopedics literature [8][9][10][11][12], but we are unaware of similar studies in the radiology literature.…”

Section: Sonography Of Screw Impingement On Extensor Tendons After Vomentioning

confidence: 63%

“…Sonography has two definite advantages in assessing extensor tendons of the wrist: It allows a dynamic examination during passive and active tendon movements and it can be used when the presence of orthopedic hardware limits use of MRI. Pathologic changes of the EPL and its tendon sheath can be detected on sonography in patients with previous distal radius fractures [6][7][8]. In a study by Owers et al [6], sonography showed thickening of both the tendon and its retinaculum in 62 patients with a radius fracture in which open reduction and internal fixation had not been performed.…”

Section: Sonography Of Screw Impingement On Extensor Tendons After Vomentioning

confidence: 99%

“…Santiago et al [8] reported on 12 patients presenting with EPL tears that were evaluated on sonography. The authors correlated the sonography appearance with CT and MRI as well as surgical findings.…”

Section: Sonography Of Screw Impingement On Extensor Tendons After Vomentioning

confidence: 99%

“…Only four of the 12 patients studied presented with tears after distal radius fractures. All were treated with Kirschner-wire fixation and not with volar plating [8]. Although the authors of several articles in the orthopedics literature have described extensor tendon tears caused by protruding screws [9][10][11][12], in none was sonography used preoperatively.…”

Section: Sonography Of Screw Impingement On Extensor Tendons After Vomentioning

confidence: 99%

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Screw Impingement on the Extensor Tendons in Distal Radius Fractures Treated by Volar Plating: Sonographic Appearance

Bianchi

Aaken²,

Glauser³

et al. 2008

American Journal of Roentgenology

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W199age, 54 years). Three right wrists and six left wrists were affected. Four patients were referred with a presumptive diagnosis of complete extensor pollicis longus (EPL) tear and three had a diagnosis of tenosynovitis; one, a dorsal mass; and one, a ganglion cyst. Patients presented with local pain (n = 8), swelling (n = 7), and inability to extend the distal phalanx of the thumb (n = 4). Informed consent was obtained to search patients' data retrospectively. Institutional review board approval was obtained.All sonography examinations were performed by a trained musculoskeletal radiologist with 22 years of experience in musculoskeletal sonography. The mean delay between surgery and sonography examination was 7 months (range, 1-27 months). The dorsal aspect of the wrist was examined on transverse and sagittal sonograms obtained while the patient was seated in front of the examiner with the pronated wrist resting on an examination table. All 12 extensor tendons, running inside the six compartments, were carefully analyzed (Fig. 1). A broadband 17-5-MHz linear transducer (model iU22, Philips Healthcare) was used. No standoff pad was used, and transmission gel was used liberally. Attention was directed to looking for changes in the internal structure of the extensor tendons, thickening of the tendons' sheaths, and evidence of synovial effusions. The presence or absence of tendon tears was noted. We also evaluated focal interruption of the dorsal cortex of the distal radius, the number and location of detectable screw tips, and the length that each screw tip protruded using electronic calipers. In M u s c u l o s ke l e t a l I m ag i ng • C l i n ic a l O b s e r v a t io n ractures of the distal radius are frequent and their incidence can be expected to increase because the older population continues to increase in number [1]. Surgical treatment allows optimal fragment reduction and is advocated when a significant dorsal tilt is present or fractures are unstable. The most commonly performed surgical procedure is open reduction and internal fixation of the volar plate [1,2]. Tendon inflammation and tears are possible complications of that procedure due to dorsally protruding screw impingement on the extensor tendons. Sonography is a readily available and atraumatic imaging technique that allows accurate and inexpensive assessment of the musculoskeletal system [3]. The extensor tendons of the wrist are well depicted by high-resolution broadband electronic transducers because of their superficial location [3,4]. We present a retrospective analysis of the sonography examinations of nine consecutive patients presenting with screw impingement on the extensor tendons examined in the past 3.5 years. ObjeCtIve. The objective of our study was to analyze the sonography examinations of nine consecutive patients with a history of distal radius fracture treated by open reduction and internal fixation of the volar plate who were referred by hand surgeons for sonography of the dorsal aspect of the wrist. Screw Impingement o...

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Section: Sonography Of Screw Impingement On Extensor Tendons After Vomentioning

confidence: 63%

Section: Sonography Of Screw Impingement On Extensor Tendons After Vomentioning

confidence: 99%

Section: Sonography Of Screw Impingement On Extensor Tendons After Vomentioning

confidence: 99%

Section: Sonography Of Screw Impingement On Extensor Tendons After Vomentioning

confidence: 99%

See 2 more Smart Citations

Screw Impingement on the Extensor Tendons in Distal Radius Fractures Treated by Volar Plating: Sonographic Appearance

Bianchi

Aaken²,

Glauser³

et al. 2008

American Journal of Roentgenology

View full text Add to dashboard Cite

show abstract

“…Magnetic resonance imaging (MRI) has fine soft tissue contrast resolution and multiplanar capability, making it a useful tool in diagnosis [3]. Ultrasound is more useful and rapid than other imaging techniques with minimal cost [4]. As a supplementary imaging modality, the specificity and positive ratio are not satisfactory using X-ray and routine computed tomographic (CT) techniques.…”

Section: Introductionmentioning

confidence: 99%

The pilot study of dual-energy CT gemstone spectral imaging on the image quality of hand tendons

Deng

Wang

et al. 2013

Clinical Imaging

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Sonography of Non‐neoplastic Disorders of the Hand and Wrist Tendons

Gitto

Draghi

2017

J of Ultrasound Medicine

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Tendon disorders commonly cause hand and wrist disability and curtail the performance of work-related duties or routine tasks. Imaging is often needed for diagnosis, but it requires knowledge of the complex anatomic structures of the tendons of the hand and wrist as well as familiarity with related disorders. This review article aims to provide medical professionals with guidelines for the sonographic assessment of the tendons of hand and wrist and related disorders. Sonographic features of tendon disorders affecting the hand and wrist are described here, specifically: infectious tenosynovitis; tendon rupture or tearing; stenosing forms of tenosynovitis such as De Quervain disease and trigger finger; intersection syndrome; insertional tendinopathy; several forms of tendinous instability such as extensor carpi ulnaris instability, climber finger, and boxer knuckle; and tendinopathy in inflammatory rheumatic diseases. Postsurgical evaluation of the hand and wrist tendons is also discussed, including the healthy and pathologic appearances of operated tendons as well as impingement from orthopedic hardware. In conclusion, sonography is effective in assessing the tendons of the hand and wrist and related disorders and represents a valuable tool for diagnosis.

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Sonography findings in tears of the extensor pollicis longus tendon and correlation with CT, MRI and surgical findings

Cited by 25 publications

References 8 publications

Screw Impingement on the Extensor Tendons in Distal Radius Fractures Treated by Volar Plating: Sonographic Appearance

Screw Impingement on the Extensor Tendons in Distal Radius Fractures Treated by Volar Plating: Sonographic Appearance

The pilot study of dual-energy CT gemstone spectral imaging on the image quality of hand tendons

Sonography of Non‐neoplastic Disorders of the Hand and Wrist Tendons

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