MR imaging of the metacarpophalangeal joints of the fingers: evaluation of 38 patients with chronic joint disability.
OBJECTIVE
To report the MR imaging findings of painful injured metacarpophalangeal (MCP) joints of the fingers.


METHODS
MR imaging of 39 injured MCP joints in 38 patients was performed after a mean delay of 8.8 months. The MR images were obtained with the fingers in extended and flexed positions using T2-weighted and T1-weighted sequences before and after intravenous injection of a gadolinium compound. Ten patients were treated surgically. Mean clinical follow-up was 1.8 years.


RESULTS
Tears of the collateral ligaments were the most common lesion (30/39), most being radial in location. Contrast-enhanced axial T1-weighted images with the MCP joint in a flexed position showed these lesions optimally. Ten tears were partial and 20 were complete. In 13 patients, MR images showed 17 associated lesions including injuries of the extensor hood (10/17), interosseous tendon (3/17), palmar plate (3/17), and an osteochondral lesion (1/17). Sagittal MR images were essential to highlight palmar plate tears.


CONCLUSIONS
Partial or complete tears of the collateral ligaments are prevalent MR imaging findings in patients with chronic disability resulting from injuries to the MCP joints. Although conservative treatment generally is sufficient for isolated injuries of the collateral ligaments, surgical repair is often required in cases of more extensive injuries. MR imaging may clearly delineate associated lesions of and about the MCP joints.
Theumann
Nicolas H
NH
Service de Radiologie B, CHU Cochin, AP-HP-Université Paris V, and CIERM, Hôpital de Bicêtre, Paris, France. Nicolas.Theumann@chuv.hospvd.ch
Pessis
Eric
E
Lecompte
Martin
M
Le Viet
Dominique
D
Valenti
Philippe
P
Chevrot
Alain
A
Bittoun
Jacques
J
Schnyder
Pierre
P
Resnick
Donald
D
Drapé
Jean-Luc
JL
D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D017885:Collateral Ligaments / Q000293:injuries / Q000473:pathology* / Q000601:surgery; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005385:Fingers / Q000473:pathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D007592:Joint Diseases / Q000175:diagnosis* / Q000601:surgery / Q000628:therapy; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D008662:Metacarpophalangeal Joint / Q000293:injuries / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D015588:Observer Variation; D009942:Organometallic Compounds; D010146:Pain / Q000209:etiology; D016059:Range of Motion, Articular; D012189:Retrospective Studies
D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine
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