Dynamic evaluation of the flexor tendons in trigger finger скачать в хорошем качестве

Dynamic evaluation of the flexor tendons in trigger finger

How should dynamic evaluation of the flexor tendons be performed when trigger finger is present in the hand? When trigger finger is present, there will be thickening of the A1 pulley visualized superficial to the flexor tendons (FDS and FDP) at the level of the metacarpophalangeal (MCP) joint. During your #ultrasound exam, the A1 pulley should be imaged and measured in the long and short axis to assess the thickness. If the thickness is more than 1.1mm, #trigger_finger is indicated. It should also be compared to the adjacent pulleys using the extended field of view feature comparing it to adjacent pulleys at the same level. The volar aspect of the #MCP_joint should be assessed as well for the presence of #hyperemia using power #doppler. A real time dynamic evaluation of the flexor #tendons during finger flexion should be performed to see if the tendons get restricted by the thickened A1 pulley during finger flexion. It is necessary to have the patient be the one to perform flexion of the affected #finger when evaluating the flexor tendons at the level of the MCP joint when trigger finger is suspected. In the first example, I was the one performing the finger flexion while I was scanning and I did not see any restriction of the flexor tendons present during the dynamic evaluation. In the second example, I had the patient perform the finger flexion themselves and it was clear that there was locking up of the superficial FDS #tendon that was not visible when I had forced the finger flexion myself. It is good to try it both ways to get a full picture of the situation. This patient presented with 3rd finger stiffness and intermittent pain. Upon clinical evaluation, I did not visualize any issues with the finger when I was performing the finger flexion initially, but I did notice some finger limitations and shaking of the finger when the patient did it. This correlated with the ultrasound findings. #tuesdaytipswithjamie #protip #dynamicultrasound #scantechnique #hand #msk #musculoskeletal #mskultrasound #sportsmedicine #ortho #orthopedicsurgeon