TY - JOUR
T1 - The Value of High-Frequency Ultrasonographic Imaging for Quantifying Trigger Digits
T2 - A Correlative Study with Clinical Findings in Patients with Different Severity Grading
AU - Chiang, Chen Hao
AU - Kuo, Li Chieh
AU - Kuo, Yao Lung
AU - Wu, Kuo Chen
AU - Shao, Chung Jung
AU - Chern, Tai Chang
AU - Jou, I. Ming
N1 - Funding Information:
The authors thank Miss Kuei-Fang Yeh for technical assistance with the ultrasonographic examination and Mr. Bill Franke for English editing. This study was supported by Grant NCKUH10002044 from National Cheng Kung University Hospital , Taiwan and, in part, by Grant NSC 99-2627-B-006-011 from the National Science Council , Taiwan.
PY - 2013/6
Y1 - 2013/6
N2 - Trigger digit is recognized as thickening and constriction of the flexor tendon sheath at the base of digits. This study investigates the correlation between the severity grading of trigger digits and clinical findings from high-frequency ultrasonography. We measured and compared thicknesses, areas and pathological changes of the flexor digit tendons among total, contracture and noncontracture trigger digits and noninvolved contralateral digits. Forty-seven patients with 55 idiopathic trigger digits (36 contracture and 19 noncontracture) and 55 noninvolved contralateral digits were examined using high-frequency ultrasonography. The thickness of the flexor tendons was measured in a longitudinal plane at the A1 pulley: Inlet (metacarpal head-neck junction), Outlet (proximal phalangeal base-shaft junction) and Interpulley (middle of Inlet and Outlet). The cross-sectional and extratendinous tissue areas of the flexor tendons in a transverse plane at the point of Interpulley were measured. Pathological changes including irregular internal echotextures, fluid collection, dominant A1 pulley and abnormal metacarpophalangeal joint were analyzed. All thicknesses and areas of total and contracture trigger digits were significantly greater than those of noninvolved contralateral digits (p < 0.05), whereas no significant difference was observed in noncontracture trigger digits. The pathological changes were all significantly different from noninvolved contralateral digits in total, contracture and noncontracture trigger digits (p < 0.05). In contracture and noncontracture trigger digits, there were significant differences only in the thickness of the Inlet and the pathological change of the dominant A1 pulley (p < 0.05). In conclusion, the results of the ultrasonographic measurements and findings provided evidence of Notta's node and correlated with clinical findings and severity grades.
AB - Trigger digit is recognized as thickening and constriction of the flexor tendon sheath at the base of digits. This study investigates the correlation between the severity grading of trigger digits and clinical findings from high-frequency ultrasonography. We measured and compared thicknesses, areas and pathological changes of the flexor digit tendons among total, contracture and noncontracture trigger digits and noninvolved contralateral digits. Forty-seven patients with 55 idiopathic trigger digits (36 contracture and 19 noncontracture) and 55 noninvolved contralateral digits were examined using high-frequency ultrasonography. The thickness of the flexor tendons was measured in a longitudinal plane at the A1 pulley: Inlet (metacarpal head-neck junction), Outlet (proximal phalangeal base-shaft junction) and Interpulley (middle of Inlet and Outlet). The cross-sectional and extratendinous tissue areas of the flexor tendons in a transverse plane at the point of Interpulley were measured. Pathological changes including irregular internal echotextures, fluid collection, dominant A1 pulley and abnormal metacarpophalangeal joint were analyzed. All thicknesses and areas of total and contracture trigger digits were significantly greater than those of noninvolved contralateral digits (p < 0.05), whereas no significant difference was observed in noncontracture trigger digits. The pathological changes were all significantly different from noninvolved contralateral digits in total, contracture and noncontracture trigger digits (p < 0.05). In contracture and noncontracture trigger digits, there were significant differences only in the thickness of the Inlet and the pathological change of the dominant A1 pulley (p < 0.05). In conclusion, the results of the ultrasonographic measurements and findings provided evidence of Notta's node and correlated with clinical findings and severity grades.
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U2 - 10.1016/j.ultrasmedbio.2013.01.005
DO - 10.1016/j.ultrasmedbio.2013.01.005
M3 - Article
C2 - 23562016
AN - SCOPUS:84877145887
SN - 0301-5629
VL - 39
SP - 967
EP - 974
JO - Ultrasound in Medicine and Biology
JF - Ultrasound in Medicine and Biology
IS - 6
ER -