Rawat Udit, Pierce Jennifer L, Evans Scott, Chhabra A Bobby, Nacey Nicholas C
From the Department of Radiology and Medical Imaging, Division of Musculoskeletal Imaging (U.R., J.L.P., N.C.N.), and Department of Orthopedic Surgery (S.E., A.B.C.), University of Virginia Health System, 1215 Lee St, Charlottesville, VA 22908.
Radiographics. 2016 Oct;36(6):1701-1716. doi: 10.1148/rg.2016160015.
Despite having many unique anatomic features relative to the other digits, the thumb has received little attention in the radiology literature. The thumb, with its opposable and prehensile abilities, enables fine manual dexterity. However, most radiologists have little familiarity with the structures that allow these dynamic movements, other than their recognition of the role of the ulnar collateral ligament in the setting of gamekeeper injury. High-resolution magnetic resonance (MR) imaging allows optimal assessment of the intricate soft-tissue anatomy of the thumb, which enables thumb flexion, extension, abduction, and adduction. Ultrasonography is a readily available, inexpensive tool that can supplement MR imaging in the evaluation of juxta-articular soft-tissue anatomy. Both imaging modalities are extremely useful for identifying the key ligaments responsible for stabilizing the first carpometacarpal and metacarpophalangeal joints. MR imaging is particularly important in assessment of these ligaments in both normal and trauma settings, which is essential for not only recognizing acute injuries but also becoming familiar with the morphologic variations that are potential pitfalls. To accurately and confidently diagnose abnormalities of these small soft-tissue structures, radiologists must have a clear understanding of the complexities associated with imaging the normal thumb anatomy. RSNA, 2016.
尽管相对于其他手指而言，拇指具有许多独特的解剖特征，但在放射学文献中，拇指受到的关注却很少。拇指具有对掌和抓握能力，能实现精细的手部灵活性。然而，大多数放射科医生除了认识到尺侧副韧带在守林人损伤中的作用外，对实现这些动态运动的结构了解甚少。高分辨率磁共振（MR）成像能够对拇指复杂的软组织解剖结构进行最佳评估，而正是这些结构使拇指能够实现屈曲、伸展、外展和内收。超声检查是一种现成的、廉价的工具，在评估关节周围软组织解剖结构时可作为MR成像的补充。这两种成像方式对于识别负责稳定第一掌腕关节和掌指关节的关键韧带都极为有用。MR成像在正常和创伤情况下对这些韧带的评估中尤为重要，这不仅对于识别急性损伤至关重要，而且对于熟悉可能造成误诊的形态学变异也必不可少。为了准确且自信地诊断这些小软组织结构的异常情况，放射科医生必须清楚了解与正常拇指解剖结构成像相关的复杂性。RSNA，2016年。
