Finger A2 pulley lesions in rock climbers: detection and characterization with magnetic resonance imaging at 3 Tesla--initial results.
OBJECTIVE
To evaluate magnetic resonance imaging (MRI) at 3 T in the diagnosis and characterization of lesions of the finger flexor A2 pulley in patients with clinically suspected A2 pulley lesions.


METHODS
Eight consecutive patients with clinically suspected lesions of the A2 pulley were included in this retrospective study. 3 T MRI was performed with T1-weighted, T2-weighted fat suppressed, and T1-weighted fat suppressed contrast enhanced sequences. The A2 pulley of all the fingers visible on the images were analyzed and pulley lesions characterized.


RESULTS
All asymptomatic pulleys were normal at MRI. In the 8 symptomatic fingers 7 pulleys were abnormal at MRI. With the clinical examination as gold standard, sensitivity, specificity, positive predictive value, and negative predictive value of MRI were 87.5%, 100%, 100%, and 95.2% respectively. Characterization of the different pulley lesion was possible.


CONCLUSIONS
MRI at 3 T allows reliable direct visualization and characterization of traumatic A2 pulley lesions.
Guntern
Daniel
D
Department of Radiology, CHUV, Lausanne, Switzerland. daniel.guntern@chuv.ch
Goncalves-Matoso
Vasco
V
Gray
Anne
A
Picht
Carmen
C
Schnyder
Pierre
P
Theumann
Nicolas
N
D000328:Adult; D003287:Contrast Media; D005260:Female; D005383:Finger Injuries / Q000175:diagnosis*; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009051:Mountaineering / Q000293:injuries*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013708:Tendon Injuries / Q000175:diagnosis*
D003287:Contrast Media; D019786:Gadolinium DTPA