Dipartimento di Scienze Radiologiche, Istituto di Radiologia, Policlinico Umberto I, Università "La Sapienza", Viale Regina Elena, 324, 00161, Rome, Italy.
Facoltà di Medicina e Odontoiatria Roma, Università degli Studi di Roma La Sapienza, Rome, Italy.
J Ultrasound. 2022 Mar;25(1):67-71. doi: 10.1007/s40477-020-00556-6. Epub 2021 Jan 6.
Our analysis focuses explicitly on applying two sonographic and morphological indexes (sesamoid index and subsesamoid index) to better evaluate post-traumatic consequences to the sesamoids of the first finger.
In 2 years, we enrolled 75 patients, divided into two groups: 60 without any history of trauma and 15 reporting hyperextension trauma of the first finger. We performed clinical and instrumental examinations (sonography and X-ray) on patients with one or more symptoms compatible with sesamoiditis, while an MRI scan was performed only on patients with an acute onset and severe symptomatology. We measured both the short and long-axis diameter (in mm) for each sesamoid as well as the relation between the two parameters (sesamoid index, SI and subsesamoid index, SubI).
All 15 patients showed sonographic alterations of the SI above the reference range, while the alterations of SubI varied according to the acuteness and gravity of trauma. In all cases, the X-ray did not show any relevant alterations. MRI scans in patients with acute symptoms confirmed the sonographic findings.
Sonography enabled diagnosis of micro-injuries which were invisible to X-Ray and allowed to detect possible damages to the sesamoid complex, providing a qualitative and quantitative evaluations of the post-traumatic alteration of the metacarpophalangeal joint of the 1st finger and is therefore valid, combined with clinical examination and hand X-ray, in the evaluation of sesamoiditis without the need to perform further examinations.
我们的分析专门侧重于应用两个超声和形态学指标（豆状骨指数和豆状骨下指数），以更好地评估第一指的豆状骨的创伤后后果。
在 2 年内，我们招募了 75 名患者，分为两组：60 名无任何创伤史，15 名报告第一指过度伸展性创伤。我们对有一个或多个与豆状骨炎相符的症状的患者进行临床和仪器检查（超声和 X 射线），而仅对有急性发作和严重症状的患者进行 MRI 扫描。我们测量了每个豆状骨的短轴和长轴直径（以毫米为单位），以及两个参数之间的关系（豆状骨指数，SI 和豆状骨下指数，SubI）。
所有 15 名患者的 SI 超声改变均高于参考范围，而 SubI 的改变则根据创伤的急性和严重程度而有所不同。在所有情况下，X 射线均未显示任何相关改变。有急性症状的患者的 MRI 扫描证实了超声检查结果。
超声检查能够诊断 X 射线无法发现的微小损伤，并能够检测到手部豆状骨复合体的可能损伤，对第一指的掌指关节的创伤后改变进行定性和定量评估，因此结合临床检查和手部 X 射线，在评估豆状骨炎时无需进行进一步检查，是有效的。
