Department of Radiology, University Hospital, LMU Munich, Muenchen, Germany.
Department of Radiology, University Hospital Wuerzburg, Germany.
Rofo. 2022 Dec;194(12):1307-1321. doi: 10.1055/a-1826-1007. Epub 2022 Jun 15.
The tendons of the hand run in close proximity to each other and within retinacular tunnels adjacent to articular joints, while forming intersections in characteristic locations. The enclosing tendon sheaths are often sites of systemic or infectious inflammation.
This review article outlines the different entities of tendon and tendon sheath pathology and their manifestation in the hands. Diagnostic findings in tendon and tendon sheath disorders are illustrated using MRI imaging and discussed in context with the current literature.
Overuse may cause stenosis in the fibrous outer layer of the retinacula and the A1 annular ligaments as well as tendinosis. In contrast, proliferative tenosynovitis is a disease of the synovial inner layer of the tendon sheath with tendon infiltration and tendinitis. Pyogenic tenosynovitis favors the flexor compartments. Because of the narrow spaces in the hand, a high-resolution MRI technique must be used.
· Diseases of the tendons and tendon sheaths may have a mechanical, degenerative, metabolic, systemic inflammatory, or infectious etiology.. · Fibrous tunnels and bony prominences in close proximity to crossing tendons predispose to mechanical tendon irritation at typical sites of the hand.. · Stenosing tenovaginitis occurs in the fibrous layer of the extensor retinaculum or the A1 annular pulleys. The most frequent manifestations are the "trigger finger" and de Quervain disease.. · Proliferative tenosynovitis affects the synovial layer of the tendon sheaths before infiltrating the tendons. The classic representative is rheumatoid arthritis..
· Schmitt R, Hesse N, Grunz JP. Tendons and Tendon Sheaths of the Hand - An Update on MRI. Fortschr Röntgenstr 2022; 194: 1307 - 1321.
手部的肌腱彼此相邻，并位于关节附近的滑膜囊中，形成特征性位置的交叉。包围肌腱的鞘通常是全身性或感染性炎症的部位。
本文综述了手部肌腱和腱鞘病变的不同实体及其表现。使用 MRI 成像描述了肌腱和腱鞘疾病的诊断发现，并结合当前文献进行了讨论。
过度使用可导致滑膜囊纤维外层和 A1 环状韧带狭窄以及腱病。相比之下，增生性腱鞘炎是一种滑膜内层疾病，伴有肌腱浸润和腱鞘炎。化脓性腱鞘炎好发于屈肌腱鞘。由于手部空间狭窄，必须使用高分辨率 MRI 技术。
·肌腱和腱鞘疾病的病因可能是机械性、退行性、代谢性、全身性炎症或感染性的。·纤维隧道和邻近交叉肌腱的骨突容易导致手部典型部位的机械性肌腱刺激。·狭窄性腱鞘炎发生在伸肌支持带的纤维层或 A1 环状滑车。最常见的表现是“扳机指”和德奎文病。·增生性腱鞘炎先影响腱鞘的滑膜层，然后浸润肌腱。典型的代表是类风湿关节炎。
Schmitt R, Hesse N, Grunz JP. Tendons and Tendon Sheaths of the Hand - An Update on MRI. Fortschr Röntgenstr 2022; 194: 1307-1321.
