掌侧纤维瘤病,与 A1 滑轮、扳机指和声学梳状征的关系的最新回顾。

IF 2.1 4区 医学 Q2 ACOUSTICS
Cody A. Pepperday DO, Naveen Murthy MD, Sanjeev Kakar MD, Gavin A. McKenzie MD
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引用次数: 0

摘要

目的:对手掌纤维瘤病(PF)的声像图外观进行最新的回顾性研究,并评估之前在足底纤维瘤中描述的 Comb Sign 的实用性。此外,还对与屈肌腱的相对位置、掌跖纤维瘤与 A1 滑轮的解剖学邻近性进行了评估,并评估了与扳机指的任何潜在关联:对 2017 年至 2023 年新发超声或临床诊断为 PF 的患者进行病历和影像学审查。回顾了临床关联和影像学形态,包括是否存在梳状征、纤维瘤与 A1 滑轮的关联以及纤维瘤与扳机指的关联:结果:共对 53 名患者的 87 个纤维瘤进行了评估。39%的纤维瘤出现梳状征,通常出现在横切面上,在多灶性疾病和较大的纤维瘤中更为常见。大多数(72%)手掌纤维瘤距离 A1 滑轮 1 厘米以内,接触或覆盖 A1 滑轮(P 结论):梳状征有助于对掌跖纤维瘤进行超声诊断。纤维瘤可向外侧延伸。大多数掌纤维瘤与 A1 滑轮有明显的密切联系,扳机指可能与邻近的掌纤维瘤同时存在,手外科医生术前了解这一点非常重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Palmar Fibromatosis, Updated Review With Relationship to the A1 Pulley, Trigger Finger, and Presence of the Sonographic Comb Sign

Objectives

Updated retrospective review of the sonographic appearance of palmar fibromatosis (PF) with evaluation of the utility of the Comb Sign previously described in plantar fibromas. Additional evaluation was conducted on the location relative to the flexor tendon, anatomic proximity of palmar fibromas to the A1 pulley and evaluate any potential association with trigger finger.

Methods

Medical record and imaging review was performed from 2017 to 2023, for patients with a new onset ultrasound or clinical diagnosis of PF. Clinical associations and imaging morphology were reviewed including presence of the Comb Sign, fibroma association with the A1 pulley, and fibroma association with trigger finger.

Results

Exactly 87 total fibromas in 53 patients were evaluated. The Comb Sign was present in 39% of fibromas, usually seen in transverse plane, more prevalent in multifocal disease and larger fibromas. Most (72%) palmar fibromas were within 1 cm of, contacted, or covered the A1 pulley (P < .001). Lateral extension beyond the flexor tendon axis can be seen (44%). Trigger finger and tenosynovitis were rare. However, volume and SI dimension of fibromas were associated with tenosynovitis (P < .0001) and all nine patients with concomitant trigger finger had fibromas within 1 cm from the A1 pulley.

Conclusions

The Comb Sign can aid in sonographic diagnosis of PF. Lateral extension of fibromas can occur. Most palmar fibromas have a significant intimate association with the A1 pulley, and presence of trigger finger with adjacent palmar fibroma can exist and is important for hand surgeons to know preoperatively.

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来源期刊
CiteScore
5.10
自引率
4.30%
发文量
205
审稿时长
1.5 months
期刊介绍: The Journal of Ultrasound in Medicine (JUM) is dedicated to the rapid, accurate publication of original articles dealing with all aspects of medical ultrasound, particularly its direct application to patient care but also relevant basic science, advances in instrumentation, and biological effects. The journal is an official publication of the American Institute of Ultrasound in Medicine and publishes articles in a variety of categories, including Original Research papers, Review Articles, Pictorial Essays, Technical Innovations, Case Series, Letters to the Editor, and more, from an international bevy of countries in a continual effort to showcase and promote advances in the ultrasound community. Represented through these efforts are a wide variety of disciplines of ultrasound, including, but not limited to: -Basic Science- Breast Ultrasound- Contrast-Enhanced Ultrasound- Dermatology- Echocardiography- Elastography- Emergency Medicine- Fetal Echocardiography- Gastrointestinal Ultrasound- General and Abdominal Ultrasound- Genitourinary Ultrasound- Gynecologic Ultrasound- Head and Neck Ultrasound- High Frequency Clinical and Preclinical Imaging- Interventional-Intraoperative Ultrasound- Musculoskeletal Ultrasound- Neurosonology- Obstetric Ultrasound- Ophthalmologic Ultrasound- Pediatric Ultrasound- Point-of-Care Ultrasound- Public Policy- Superficial Structures- Therapeutic Ultrasound- Ultrasound Education- Ultrasound in Global Health- Urologic Ultrasound- Vascular Ultrasound
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