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Thumb ultrasound: Technique and pathologies

View Article: PubMed Central - PubMed

ABSTRACT

Ultrasound is ideally suited for the assessment of complex anatomy and pathologies of the thumb. Focused and dynamic thumb ultrasound can provide a rapid real-time diagnosis and can be used for guided treatment in certain clinical situations. We present a simplified approach to scanning technique for thumb-related pathologies and illustrate a spectrum of common and uncommon pathologies encountered.

No MeSH data available.


Related in: MedlinePlus

De Quervain's tenosynovitis (A-H). Schematic diagram (A) shows thickened extensor retinaculum (in purple) around the 1st extensor tendons. Short (B) and long axis (C) ultrasound show thickened extensor retinaculum (red arrow) with swollen 1st compartment tendons (blue arrow). Short axis ultrasound images show peritendinous fluid (white arrow) (E), increased retinaculum vascularity (red arrow) (F), intratendinous Doppler flow (yellow arrow) (G), isolated EPB tendon involvement (open arrow) with septa (green arrow) and multiple 1st extensor compartment tendon slips (black arrow)
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Figure 5: De Quervain's tenosynovitis (A-H). Schematic diagram (A) shows thickened extensor retinaculum (in purple) around the 1st extensor tendons. Short (B) and long axis (C) ultrasound show thickened extensor retinaculum (red arrow) with swollen 1st compartment tendons (blue arrow). Short axis ultrasound images show peritendinous fluid (white arrow) (E), increased retinaculum vascularity (red arrow) (F), intratendinous Doppler flow (yellow arrow) (G), isolated EPB tendon involvement (open arrow) with septa (green arrow) and multiple 1st extensor compartment tendon slips (black arrow)

Mentions: Overuse tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons in the first extensor compartment (EC) is termed as De Quervain's tenosynovitis. It causes pain around the radial styloid associated with the movement of the thumb. The clinical diagnosis of de Quervain's tenosynovitis is usually straightforward using Finkelstein's test. Ultrasound [Figure 5A–G] is used to confirm the diagnosis, exclude underlying tendinosis or tendon tear, assess the retinaculum, detect whether septa are present within the first extensor compartment, and guide steroid injection [Video 2] into the tendon sheath or retinacular division in resistant cases. The APL or less commonly EPB tendon may have multiple tendon slips [Figure 5H], which should not be mistaken for longitudinal tendon clefts or tears.[2] The appearance of multiple tendon slips has been termed “the lotus root sign” because the multiple tendons appear similar to a cut lotus root.[3]


Thumb ultrasound: Technique and pathologies
De Quervain's tenosynovitis (A-H). Schematic diagram (A) shows thickened extensor retinaculum (in purple) around the 1st extensor tendons. Short (B) and long axis (C) ultrasound show thickened extensor retinaculum (red arrow) with swollen 1st compartment tendons (blue arrow). Short axis ultrasound images show peritendinous fluid (white arrow) (E), increased retinaculum vascularity (red arrow) (F), intratendinous Doppler flow (yellow arrow) (G), isolated EPB tendon involvement (open arrow) with septa (green arrow) and multiple 1st extensor compartment tendon slips (black arrow)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036340&req=5

Figure 5: De Quervain's tenosynovitis (A-H). Schematic diagram (A) shows thickened extensor retinaculum (in purple) around the 1st extensor tendons. Short (B) and long axis (C) ultrasound show thickened extensor retinaculum (red arrow) with swollen 1st compartment tendons (blue arrow). Short axis ultrasound images show peritendinous fluid (white arrow) (E), increased retinaculum vascularity (red arrow) (F), intratendinous Doppler flow (yellow arrow) (G), isolated EPB tendon involvement (open arrow) with septa (green arrow) and multiple 1st extensor compartment tendon slips (black arrow)
Mentions: Overuse tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons in the first extensor compartment (EC) is termed as De Quervain's tenosynovitis. It causes pain around the radial styloid associated with the movement of the thumb. The clinical diagnosis of de Quervain's tenosynovitis is usually straightforward using Finkelstein's test. Ultrasound [Figure 5A–G] is used to confirm the diagnosis, exclude underlying tendinosis or tendon tear, assess the retinaculum, detect whether septa are present within the first extensor compartment, and guide steroid injection [Video 2] into the tendon sheath or retinacular division in resistant cases. The APL or less commonly EPB tendon may have multiple tendon slips [Figure 5H], which should not be mistaken for longitudinal tendon clefts or tears.[2] The appearance of multiple tendon slips has been termed “the lotus root sign” because the multiple tendons appear similar to a cut lotus root.[3]

View Article: PubMed Central - PubMed

ABSTRACT

Ultrasound is ideally suited for the assessment of complex anatomy and pathologies of the thumb. Focused and dynamic thumb ultrasound can provide a rapid real-time diagnosis and can be used for guided treatment in certain clinical situations. We present a simplified approach to scanning technique for thumb-related pathologies and illustrate a spectrum of common and uncommon pathologies encountered.

No MeSH data available.


Related in: MedlinePlus