De Maeseneer Michel, Meng Jie, Marcelis Stefaan, Jager Tjeerd, Provyn Steven, Shahabpour Maryam
Vrije Universiteit Brussel , Brussels , Belgium ; Department of Radiology, Radiologie Buggenhout , Buggenhout , Belgium.
Department of Ultrasound, Jilin University , Changchun Jilin , China.
J Ultrason. 2020;20(81):e122-e128. doi: 10.15557/JoU.2020.0020. Epub 2020 Jun 15.
Many anatomical details and variants occur in the finger tendons and soft tissue structures. These may lead to misdiagnosis if the radiologist is not well aware of them. We discuss the midhand extensor tendons, dorsal hood, junctura tendinea, conjoint tendons, transverse retinacular ligament, triangular ligament as well as central and distal slip anatomy and ultrasound correlation. The dorsal hood is an important structure to center the tendons at the midportion of the MCP heads, and the sagittal bands are its main components. Two tendons are present at the second digit, and two or more at the fifth digit. The extensor mechanism is anatomically interrelated with the palmar lumbricals and interosseous tendons. At the palmar side, the flexor superficialis and profundus tendons show varying relationships along the finger. The flexor profundus passes through an opening in the flexor superficialis. We also discuss the chiasma crurale, ridges at the flexor superficialis insertions and bifid flexor profundus tendon. Although a typical distribution of annular pulleys can be observed, many variants may be present of which we address some. The volar plate is a midline fibro-cartilaginous meniscus attached proximally to the well-identifiable checkrein ligaments and distally to the base of the phalanges. Knowledge of these details and variations allows for better understanding of the finger and hand ultrasound. Many anatomical details and variants occur in the finger tendons and soft tissue structures. These may lead to misdiagnosis if the radiologist is not well aware of them. We discuss the midhand extensor tendons, dorsal hood, junctura tendinea, conjoint tendons, transverse retinacular ligament, triangular ligament as well as central and distal slip anatomy and ultrasound correlation. The dorsal hood is an important structure to center the tendons at the midportion of the MCP heads, and the sagittal bands are its main components. Two tendons are present at the second digit, and two or more at the fifth digit. The extensor mechanism is anatomically interrelated with the palmar lumbricals and interosseous tendons. At the palmar side, the flexor superficialis and profundus tendons show varying relationships along the finger. The flexor profundus passes through an opening in the flexor superficialis. We also discuss the chiasma crurale, ridges at the flexor superficialis insertions and bifid flexor profundus tendon. Although a typical distribution of annular pulleys can be observed, many variants may be present of which we address some. The volar plate is a midline fibro-cartilaginous meniscus attached proximally to the well-identifiable checkrein ligaments and distally to the base of the phalanges. Knowledge of these details and variations allows for better understanding of the finger and hand ultrasound.
手指肌腱和软组织结构存在许多解剖学细节和变异情况。如果放射科医生对此不太了解，这些情况可能会导致误诊。我们讨论了手部中间的伸肌腱、背侧腱帽、腱间结合、联合腱、横韧带、三角韧带以及中央和远侧腱束的解剖结构及其与超声的相关性。背侧腱帽是使肌腱在掌指关节头部中部居中的重要结构，矢状带是其主要组成部分。食指有两条肌腱，小指有两条或更多肌腱。伸肌装置在解剖学上与掌侧蚓状肌和骨间肌腱相互关联。在手掌侧，指浅屈肌腱和指深屈肌腱在手指上呈现出不同的关系。指深屈肌腱穿过指浅屈肌腱的一个开口。我们还讨论了交叉韧带、指浅屈肌腱附着处的嵴以及指深屈肌腱分叉。尽管可以观察到典型的环状滑车分布，但也可能存在许多变异情况，我们在此讨论其中一些。掌侧板是一条中线纤维软骨半月板，近端附着于可明确识别的牵制韧带，远端附着于指骨基部。了解这些细节和变异情况有助于更好地理解手指和手部超声检查。手指肌腱和软组织结构存在许多解剖学细节和变异情况。如果放射科医生对此不太了解，这些情况可能会导致误诊。我们讨论了手部中间的伸肌腱、背侧腱帽、腱间结合、联合腱、横韧带、三角韧带以及中央和远侧腱束的解剖结构及其与超声的相关性。背侧腱帽是使肌腱在掌指关节头部中部居中的重要结构，矢状带是其主要组成部分。食指有两条肌腱，小指有两条或更多肌腱。伸肌装置在解剖学上与掌侧蚓状肌和骨间肌腱相互关联。在手掌侧，指浅屈肌腱和指深屈肌腱在手指上呈现出不同的关系。指深屈肌腱穿过指浅屈肌腱的一个开口。我们还讨论了交叉韧带、指浅屈肌腱附着处的嵴以及指深屈肌腱分叉。尽管可以观察到典型的环状滑车分布，但也可能存在许多变异情况，我们在此讨论其中一些。掌侧板是一条中线纤维软骨半月板，近端附着于可明确识别的牵制韧带，远端附着于指骨基部。了解这些细节和变异情况有助于更好地理解手指和手部超声检查。
