About dynamic msk imaging modalities in the study of post-traumatic metacarpal fracture
Acute 4th metacarpal spiroid fracture of a professional football goalkeeper; first diagnosis was made directly on pitch with an ultrasound examination. Plain radiographs and Mri exam were performed just one hour after trauma.
One month after surgical fixation the fracture is studied with dynamic US, Mri and Cone-Beam CT imaging. The US and MR dynamic evaluations, show a regular tendon sliding over the fixation devices.
No metal-induced artifacts were seen, allowing a perfect visualization of the implanted devices.
Cone-Beam CT Sagittal (left) and Coronal (right) reconstructions.
The study was completed with dynamic Mri (0.3 Tesla) and Cone-Beam CT scans, performed with active flexion-extension of carpal-metacarpal joint structures.
About Mri and Ultrasound study of palmar fibromatosis of the hand.
This fibrosing hand disorder often leads to progressive and debilitating flexion contractures of the fingers. The diagnosis is made clinically but defining how much a fibrous nodule infiltrates a tendon is a keyelement in the diagnosis and treatment strategy, especially because recurrence after surgery is common.
For this reason I always perform both Mri and ultrasound examinations in my daily practice. Always.
Sagittal (left) and Axial (right) T2w Mri scans (0.3 Tesla); red arrows indicate the fibrous nodule and flexor tendons.
The video below demonstrates the nodule traction on the underlying flexor tendons, resulting in flexion contractures of the digits (Dupuytren contractures).