利用拇长屈肌腱横截面积诊断拇长屈肌腱腱鞘炎

Diagnosis of flexor hallucis longus tenosynovitis using the cross-sectional area of the flexor hallucis longus tendon.

作者信息

Park SoYoon, Kim Young Uk

机构信息

Department of Anesthesiology and Pain Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea.

出版信息

Korean J Anesthesiol. 2025 Oct;78(5):482-487. doi: 10.4097/kja.24773. Epub 2025 May 23.

DOI:10.4097/kja.24773

PMID:40405501

Abstract

BACKGROUND

Flexor hallucis longus tenosynovitis (FHLTS) is the inflammation of the sheath through which the flexor hallucis longus tendon (FHLT) passes. The FHLT thickness (FHLTT) is correlated with ankle pain. Thus, the FHLTT is considered a characteristic FHLTS feature. However, asymmetrical thickening of the FHLT can occur at any point. Therefore, we used the FHLT cross-sectional area (FHLTCSA) as a new morphological parameter to diagnose FHLTS.

METHODS

26 participants in the Control group (Group 1) and 26 in the FHLTS group (Group 2) underwent magnetic resonance imaging. The FHLTCSA was calculated for the ligament based on the images showing the maximum hypertrophic changes. The FHLTT was measured based on the images showing the FHLT with the maximum thickness.

RESULTS

The mean FHLTCSA was 7.86 ± 1.88 mm2 and 13.11 ± 2.31 mm2 in Groups 1 and 2, respectively. The average FHLTT was 2.35 ± 0.55 mm and 2.91 ± 0.37 mm in Groups 1 and 2, respectively. The FHLTCSA (P < 0.001) and FHLTT (P < 0.001) in Group 2 were significantly greater than those in Group 1. Receiver operating characteristic curve analysis revealed that the optimal cutoff value for the FHLTCSA was 10.37 mm2, with a sensitivity of 92.3%, a specificity of 92.3%, and an area under the curve (AUC) of 0.97. The optimal cutoff value for the FHLTT was 2.71 mm, with a sensitivity of 76.9%, a specificity of 76.9%, and an AUC of 0.84.

CONCLUSIONS

The FHLTCSA is a sensitive morphological parameter for assessing FHLTS.

摘要

背景

拇长屈肌腱腱鞘炎（FHLTS）是拇长屈肌腱（FHLT）所通过的腱鞘的炎症。拇长屈肌腱厚度（FHLTT）与踝关节疼痛相关。因此，FHLTT被认为是FHLTS的一个特征性表现。然而，FHLT的不对称增厚可发生在任何部位。因此，我们使用拇长屈肌腱横截面积（FHLTCSA）作为诊断FHLTS的一个新的形态学参数。

方法

26名对照组参与者（第1组）和26名FHLTS组参与者（第2组）接受了磁共振成像检查。根据显示最大肥厚变化的图像计算韧带的FHLTCSA。根据显示FHLT最大厚度的图像测量FHLTT。

结果

第1组和第2组的平均FHLTCSA分别为7.86±1.88mm²和13.11±2.31mm²。第1组和第2组的平均FHLTT分别为2.35±0.55mm和2.91±0.37mm。第2组的FHLTCSA（P<0.001）和FHLTT（P<0.001）显著大于第1组。受试者工作特征曲线分析显示，FHLTCSA的最佳截断值为10.37mm²，灵敏度为92.3%，特异性为92.3%，曲线下面积（AUC）为0.97。FHLTT的最佳截断值为2.71mm，灵敏度为76.9%，特异性为76.9%，AUC为0.84。