Sagittal Band Injury

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Sagittal Band Injury

Authors, Editors, Case Information Author: Tyler Schmitz, DO Affiliation: Blue Ridge Orthopedics Senior Editor: William Denq, MD Clinical Vignette: 38 year old female presented with a right hand injury that occurred 1 month ago when she crushed her long finger knuckle in between a sled and the ground while snow sledding. Examination of the 3rd MCP joint demonstrated swelling at the dorsal aspect, pain with flexion, and snapping at the knuckle. Type of Probe Used: 15-6 MHz Linear Transducer Proximal SB at rest - unlabeled Short axis view to the central band of the extensor tendon at the proximal third MCP joint with long finger at rest. Proximal SB at rest - labeled Short axis view to the central band of the extensor tendon at the proximal third MCP joint with long finger at rest. Distal SB at rest - unlabeled Short axis view to the central band of the extensor tendon at the third metacarpal head with the long finger at rest. Distal SB at rest - labeled There is some hypoechoic thickening of the distal part of the radial sagittal band compared to the ulnar sagittal band with the long finger at rest at the location of the metacarpal head. ET with flexion - unlabeled Short axis view to the central band of the extensor tendon at the third MCP joint with the MCP joint flexed. ET with flexion - labeled There is ulnar subluxation of the extensor tendon relative to the metacarpal head with MCP joint flexion. Interpretation Image Interpretation: Radial sagittal band injury of the long finger MCP joint with extensor tendon subluxation/instability (Type II) Teaching Pearl: It is important to perform dynamic testing of the extensor tendon to evaluate for tendon instability. The tendon may subluxate or dislocate with MCP joint flexion, usually to the contralateral side of the injury.
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Authors, Editors, Case Information

Proximal SB at rest - unlabeled

Proximal SB at rest - labeled

Distal SB at rest - unlabeled

Distal SB at rest - labeled

ET with flexion - unlabeled

ET with flexion - labeled

Interpretation

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