Rheumatology International

, Volume 30, Issue 11, pp 1455–1458 | Cite as

Ultrasonographic assessment of clinically diagnosed trigger fingers

  • Hae-Rim Kim
  • Sang-Heon LeeEmail author
Original Article


This study examines flexor digitorum tendons and A1 pulley in patients presenting trigger fingers using high-resolution ultrasonography (US), determines the accurate causes of trigger fingers, and analyzes the relationship between clinical data and US findings. As much as 50 trigger fingers of 41 patients were examined by high-resolution US, and the US findings were analyzed as tendon thickness, fibrillar echotexture, tendon margin, fluid collection, A1 pulley thickening, tendon sheath cyst, and metacarpophalageal (MCP) joint abnormalities. The affected fingers were compared with the asymptomatic opposite sides. Right thumb and ring finger were the most common fingers involved. Mean thickness of flexor digitorum tendons of the affected fingers was increased significantly, compared with that of the opposite fingers. There were various US findings in flexor digitorum tendons as follows; loss of normal fibrillar echogenic pattern (14%), irregularity or blurring of the tendon margin (62%), and fluid collection in the tendon sheath (16%). Thickening of A1 pulley was noted in 44% of fingers, and mean thickness of A1 pulley was 0.7 mm. As much as 6% of fingers had the sheath cysts and 4% of fingers had abnormalities of MCP joints. The patients with extension difficulty of the fingers had thicker flexor digitorum tendon than those without. The patients with locking fingers had more blurred margin of the tendon than those without. US can detect various lesions in clinical trigger fingers, and some US findings correlated with clinical findings.


Trigger finger Ultrasonography Arthralgia Finger 



This work was supported by the Konkuk University Medical Center Research Grant 2008.

Conflict of interest statement

We declare that there is no conflict of interest.


  1. 1.
    Akhtar S, Bradley MJ, Quinton DN, Burke FD (2005) Management and referral for trigger finger/thumb. BMJ (Clin Res Ed) 331(7507):30–33CrossRefGoogle Scholar
  2. 2.
    Ryzewicz M, Wolf JM (2006) Trigger digits: principles, management, and complications. J Hand Surg 31(1):135–146CrossRefGoogle Scholar
  3. 3.
    Nimigan AS, Ross DC, Gan BS (2006) Steroid injections in the management of trigger fingers. Am J Phys Med Rehabil 85(1):36–43CrossRefPubMedGoogle Scholar
  4. 4.
    Moore JS (2000) Flexor tendon entrapment of the digits (trigger finger and trigger thumb). J Occup Environ Med 42(5):526–545CrossRefPubMedGoogle Scholar
  5. 5.
    Sampson SP, Badalamente MA, Hurst LC, Seidman J (1991) Pathobiology of the human A1 pulley in trigger finger. J Hand Surg 16(4):714–721CrossRefGoogle Scholar
  6. 6.
    Saldana MJ (2001) Trigger digits: diagnosis and treatment. J Am Acad Orthop Surg 9(4):246–252PubMedGoogle Scholar
  7. 7.
    Matsui Y, Kawabata H, Yasui N (2002) Multiple trigger fingers associated with geleophysic dysplasia. Arch Orthop Trauma Surg 122(6):371–372PubMedGoogle Scholar
  8. 8.
    Serafini G, Derchi LE, Quadri P, Martinoli C, Orio O, Cavallo A, Gandolfo N (1996) High resolution sonography of the flexor tendons in trigger fingers. J Ultrasound Med 15(3):213–219PubMedGoogle Scholar
  9. 9.
    Fujiwara M (2005) A case of trigger finger following partial laceration of flexor digitorum superficialis and review of the literature. Arch Orthop Trauma Surg 125(6):430–432CrossRefPubMedGoogle Scholar
  10. 10.
    Khoury V, Cardinal E, Bureau NJ (2007) Musculoskeletal sonography: a dynamic tool for usual and unusual disorders. AJR 188(1):W63–W73CrossRefPubMedGoogle Scholar
  11. 11.
    Lee JC, Healy JC (2005) Normal sonographic anatomy of the wrist and hand. Radiographics 25(6):1577–1590CrossRefPubMedGoogle Scholar
  12. 12.
    Lee DH, Robbin ML, Galliott R, Graveman VA (2000) Ultrasound evaluation of flexor tendon lacerations. J Hand Surg 25(2):236–241CrossRefGoogle Scholar
  13. 13.
    Klauser A, Frauscher F, Bodner G, Halpern EJ, Schocke MF, Springer P, Gabl M, Judmaier W, zur Nedden D (2002) Finger pulley injuries in extreme rock climbers: depiction with dynamic US. Radiology 222(3):755–761CrossRefPubMedGoogle Scholar
  14. 14.
    Klauser A, Stadlbauer KH, Frauscher F, Herold M, Klima G, Schirmer M, zur Nedden D (2004) Value of transducer positions in the measurement of finger flexor tendon thickness by sonography. J Ultrasound Med 23(3):331–337PubMedGoogle Scholar
  15. 15.
    Boutry N, Titecat M, Demondion X, Glaude E, Fontaine C, Cotten A (2005) High-frequency ultrasonographic examination of the finger pulley system. J Ultrasound Med 24(10):1333–1339PubMedGoogle Scholar
  16. 16.
    Bianchi S, Martinoli C, Abdelwahab IF (1999) High-frequency ultrasound examination of the wrist and hand. Skeletal Radiol 28(3):121–129CrossRefPubMedGoogle Scholar
  17. 17.
    Jacob D, Cohen M, Bianchi S (2007) Ultrasound imaging of non-traumatic lesions of wrist and hand tendons. Eur Radiol 17(9):2237–2247CrossRefPubMedGoogle Scholar
  18. 18.
    Martinoli C, Bianchi S, Dahmane M, Pugliese F, Bianchi-Zamorani MP, Valle M (2002) Ultrasound of tendons and nerves. Eur Radiol 12(1):44–55CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  1. 1.Division of Rheumatology, Department of Internal MedicineKonkuk University Hospital, Konkuk University School of MedicineSeoulKorea

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