Role of Ultrasound in Evaluation of Tendon and Ligament Abnormalities in Hand and Fingers

The hand and fingers are the most important functional parts of the body in daily life activities and are prone to traumatic injuries and susceptible to a wide array of inflammatory diseases. Tendon abnormalities of the hand and the fingers are common disorders, particularly among athletes and in the elderly. These abnormalities may be symptomatic degenerative changes, inflammatory, or rupture. Tendon disorders are a common cause of pain and loss of function. Chronic tendon disorders are much more common than acute injuries and are the result of overuse or age-related tendon degeneration.

There is a wide spectrum of hand and finger pathological conditions that can be demonstrated using Ultrasonography. Superficial structures of the wrist, hand, and fingers, including the tendons, ligaments, nerves, and vessels, are amenable to imaging with high-frequency US. US can depict masses and fluid collections, help locate radiolucent foreign bodies, characterize traumatic or overuse tendon or ligament pathology, and help evaluate compressive peripheral neuropathy and microvascular blood flow. Additionally, this modality improves the accuracy of therapeutic intra-articular or peritendinous injections and facilitates aspiration of fluid collections, such as ganglia.

Due to the improvement of imaging techniques in the last years, the performance of ultrasonography (US) in detecting pathological changes in the musculoskeletal system dramatically increased. Moreover, dynamic examination allows better evaluation of the type and extension of the lesions. An anatomical course of the nerves and tendons can be depicted by US, thus offering valuable information on the exact location and type of possible lesions.

The role of USG in the assessment of tendon disorders is steadily increasing due to its being low cost, fast, wide-spread availability, and non-invasive. Additionally, it may offer a dynamic assessment of the flexor and extensor tendons, collateral ligaments, and supporting structures of the fingers, such as the extensor hood and the volar plate, as well as space-occupying lesions.

The quality of USG assessment of anatomical structures in the hand has highly improved over the last time. The development of high resolution with the highest possible frequency of modern ultrasound equipment and the superficial location of most tendons allows the spectrum of tendon abnormalities to be easily depicted with USG. US facilitates dynamic, real-time evaluation of bones, joints, tendons, nerves, and vessels, making it an ideal imaging modality for hand and finger conditions.