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MRI of the thumb: anatomy and spectrum of findings in asymptomatic volunteers


Hirschmann, Anna; Sutter, Reto; Schweizer, Andreas; Pfirrmann, Christian W A (2014). MRI of the thumb: anatomy and spectrum of findings in asymptomatic volunteers. American Journal of Roentgenology, 202(4):819-827.

Abstract

OBJECTIVE.:The purpose of this article is to analyze the MR anatomy and variable imaging characteristics of the thumb in asymptomatic volunteers. SUBJECTS AND METHODS MRI of the thumb was obtained in 34 asymptomatic volunteers (mean age, 33.9 ± 9.2 years). Two radiologists independently assessed visibility and signal intensity (SI) and thickness of the following structures of the metacarpophalangeal and interphalangeal joints: proper and accessory radial and ulnar collateral ligaments, volar and dorsal plates, adductor pollicis aponeurosis, and annular pulleys. The presence and size of a synovial recess at the base of all plates was assessed. RESULTS On intermediate-weighted fat-saturated images, the ulnar collateral ligament of the metacarpophalangeal joint (reader 1, 79%; reader 2, 62%) and the adductor pollicis aponeurosis (reader 1, 50%; reader 2, 82%) commonly had a striated appearance. The radial collateral ligament of both joints was mainly of low SI (metacarpophalangeal joint, 53% for reader 1 and 85% for reader 2; interphalangeal joint, 59% for reader 1 and 82% for reader 2). All four pulleys were visible in each volunteer. An intermediate SI was observed in almost all pulleys, whereas the variable annular pulley had predominantly a low SI (reader 1, 50%; reader 2, 74%). The ulnar collateral ligament of the metacarpophalangeal joint is typically less than 3 mm thick, and the radial collateral ligament is less than 2 mm thick. A full-thickness synovial recess at the base of the dorsal plate of the metacarpophalangeal joint was seen in almost all volunteers (reader 1, 97%; reader 2, 100%). CONCLUSION The ligaments and pulleys of the thumb show considerable variability on MRI in healthy volunteers. The ulnar collateral ligament of the metacarpophalangeal joint is typically striated and less than 3 mm thick. A full-thickness synovial recess at the base of the dorsal plate of the metacarpophalangeal joint is a normal finding and should not be misdiagnosed as a tear.

OBJECTIVE.:The purpose of this article is to analyze the MR anatomy and variable imaging characteristics of the thumb in asymptomatic volunteers. SUBJECTS AND METHODS MRI of the thumb was obtained in 34 asymptomatic volunteers (mean age, 33.9 ± 9.2 years). Two radiologists independently assessed visibility and signal intensity (SI) and thickness of the following structures of the metacarpophalangeal and interphalangeal joints: proper and accessory radial and ulnar collateral ligaments, volar and dorsal plates, adductor pollicis aponeurosis, and annular pulleys. The presence and size of a synovial recess at the base of all plates was assessed. RESULTS On intermediate-weighted fat-saturated images, the ulnar collateral ligament of the metacarpophalangeal joint (reader 1, 79%; reader 2, 62%) and the adductor pollicis aponeurosis (reader 1, 50%; reader 2, 82%) commonly had a striated appearance. The radial collateral ligament of both joints was mainly of low SI (metacarpophalangeal joint, 53% for reader 1 and 85% for reader 2; interphalangeal joint, 59% for reader 1 and 82% for reader 2). All four pulleys were visible in each volunteer. An intermediate SI was observed in almost all pulleys, whereas the variable annular pulley had predominantly a low SI (reader 1, 50%; reader 2, 74%). The ulnar collateral ligament of the metacarpophalangeal joint is typically less than 3 mm thick, and the radial collateral ligament is less than 2 mm thick. A full-thickness synovial recess at the base of the dorsal plate of the metacarpophalangeal joint was seen in almost all volunteers (reader 1, 97%; reader 2, 100%). CONCLUSION The ligaments and pulleys of the thumb show considerable variability on MRI in healthy volunteers. The ulnar collateral ligament of the metacarpophalangeal joint is typically striated and less than 3 mm thick. A full-thickness synovial recess at the base of the dorsal plate of the metacarpophalangeal joint is a normal finding and should not be misdiagnosed as a tear.

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3 citations in Web of Science®
3 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Date:April 2014
Deposited On:16 Jan 2015 13:58
Last Modified:05 Apr 2016 18:47
Publisher:American Roentgen Ray Society
ISSN:0361-803X
Publisher DOI:https://doi.org/10.2214/AJR.13.11397
PubMed ID:24660712

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