title: Stress examination of flexor tendon pulley rupture in the crimp grip position: a 1.5-Tesla MRI cadaver study.
abstract: OBJECTIVE
  The objectives of this study were the evaluation of flexor tendon pulley rupture of the fingers in the crimp grip position using magnetic resonance imaging (MRI) and the comparison of the results with MRI in the neutral position in a cadaver study.
  
  
  METHODS
  MRI in the crimp grip position and in the neutral position was performed in 21 cadaver fingers with artificially created flexor tendon pulley tears (combined pulley rupture, n = 14; single pulley rupture, n = 7). Measurement of the distance between the tendon and bone was performed. Images were evaluated by two readers, first independently and in cases of discrepancy in consensus. Sensitivity and specificity for detecting combined pulley ruptures were calculated.
  
  
  RESULTS
  Tendon bone distances were significantly higher in the crimp grip position than in the neutral position. Sensitivity and specificity for detecting combined pulley rupture were 92.86 % and 100 % respectively in the crimp grip position and 78.57 % and 85.71 % respectively in the neutral position. Kappa values for interobserver reliability were 0.87 in the crimp grip position and 0.59 in the neutral position.
  
  
  CONCLUSIONS
  MRI examination in the crimp grip position results in higher tendon bone distances by subjecting the pulleys to a higher strain, which facilitates image evaluation with higher interobserver reliability, higher sensitivity, and higher specificity for combined pulley rupture compared with examination in the neutral position.
authors.affiliation: Department of Radiology, University of Erlangen-Nuremberg, Maximiliansplatz 1, 91054, Erlangen, Germany, thomas.bayer@uk-erlangen.de.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bayer
authors.forename: Simon
authors.initials: S
authors.lastname: Fries
authors.forename: Andreas
authors.initials: A
authors.lastname: Schweizer
authors.forename: Isabelle
authors.initials: I
authors.lastname: Schöffl
authors.forename: Rolf
authors.initials: R
authors.lastname: Janka
authors.forename: Georg
authors.initials: G
authors.lastname: Bongartz
mesh_terms: D002102:Cadaver; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D056888:Patient Positioning / Q000379:methods*; D013314:Stress, Mechanical; D013708:Tendon Injuries / Q000473:pathology*; D013710:Tendons / Q000473:pathology*