Sonographic appearance of trigger fingers.
OBJECTIVE
The purpose of this study was to describe the sonographic appearance of the first annular (A1) pulley-flexor tendon complex in patients with trigger fingers.


METHODS
Thirty-three trigger fingers in 33 patients were examined with a 7- to 15-MHz probe. A control group consisted of 20 patients without trigger fingers. The study included systematic measurement of the thickness of the A1 pulley and a power Doppler assessment of the pulleys, tendons, and tendon sheaths.


RESULTS
Thickening and hypoechogenicity of the A1 pulley were found in all patients with trigger fingers. Measurements of A1 pulley thickness were significantly different (P < .0001) between the groups without trigger fingers (mean, 0.5 mm; range, 0.4-0.6 mm) and with trigger fingers (mean, 1.8 mm; range, 1.1-2.9 mm). Hypervascularization of the A1 pulley on power Doppler imaging was found in 91% of the trigger fingers but was never found in the healthy control group. Flexor tendinosis was found in 48% of the trigger fingers; tenosynovitis was found in 55%; and both were found in 39%. In the control group, tenosynovitis and tendinosis were not found.


CONCLUSIONS
Thickening and hyper-vascularization of the A1 pulley are the hallmarks of trigger fingers on sonography. Other frequently observed features include distal flexor tendinosis and tenosynovitis.
Guerini
Henri
H
Department of Radiology B, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France. henri.guerini@cch.aphp.fr
Pessis
Eric
E
Theumann
Nicolas
N
Le Quintrec
Janine-Sophie
JS
Campagna
Raphaël
R
Chevrot
Alain
A
Feydy
Antoine
A
Drapé
Jean-Luc
JL
D000368:Aged; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging*; D005385:Fingers / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D052582:Trigger Finger Disorder / Q000175:diagnosis*; D014463:Ultrasonography / Q000379:methods*