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Ultrasound Med Biol. 2014 Jun;40(6):1146-53. doi: 10.1016/j.ultrasmedbio.2014.01.009. Epub 2014 Mar 6.

Sonographic analyses of pulley and flexor tendon in idiopathic trigger finger with interphalangeal joint contracture.

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  • 1Ishii Orthopaedic & Rehabilitation Clinic, Gyoda, Saitama, Japan. Electronic address:
  • 2Ishii Orthopaedic & Rehabilitation Clinic, Gyoda, Saitama, Japan.


This study investigated the sonographic appearance of the pulley and flexor tendon in idiopathic trigger finger in correlation with the contracture of the interphalangeal (IP) joint in the thumb or proximal IP (PIP) joint in the other digits. Sonographic measurements using axial images were performed in 177 affected digits including 17 thumbs and 34 other digits judged to have IP or PIP joint contracture and 77 contralateral control digits. The A1 pulley of the contracture group was significantly thicker than that of the non-contracture group in all digits, whereas the flexor tendon was thicker only in digits other than the thumb. In the analysis using calculated cut-off values, A1 pulley thickening in the thumb and A1 pulley and flexor tendon thickening in the other digits showed statistically significant correlations with IP or PIP joint contracture. This study sonographically confirmed previous reports showing that enlargement of the flexor tendons contribute to the pathogenesis of PIP joint contracture.


Flexor tendon; Interphalangeal joint contracture; Proximal interphalangeal joint contracture; Pulley; Trigger finger; Ultrasonography

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