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omers66
Nov 21, 2011, 5:26 PM
Post #1 of 3
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Registered: Aug 11, 2011
Posts: 3
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Im having this problem with the A1/A2 pulley for a while.
I have done an ultrasound scan that shows nothing.
Does Ultrasound scan show finger pulley?
Thanks
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cracklover
Nov 21, 2011, 5:50 PM
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Registered: Nov 14, 2002
Posts: 10162
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I am no expert, but from what I have read, the only way you will see a pulley injury on US is if there is a full rupture, and you can image the bowstringing. For a minor tear, an MRI is better, but won't always see it.
Cheers,
GO
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altelis
Dec 8, 2011, 10:51 PM
Post #3 of 3
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Registered: Nov 10, 2004
Posts: 2168
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So, I partially tore my A1 last year, and after my orthopod sent me to get a T4 MRI (aka MRI with BIG magnet), i did a lit search. From what I remember, u/s has very comparable sensitivity and specificity to MRI if the radiologist has the proper experience & training.
The "catch" is that most radiologist are adept at soft tissue reads of u/s of the hand. That said, most aren't great at doing those same reads of MRI's. My MRI came back clean, but the orthopod wasn't convinced given my exam and his read. So he had a local radiologist he knows who specializes in orthopedic radiology take a look and he saw a small tear.
One problem in orthopedics that bears mentioning here is that MRI is TOO good. This issue is starting to get more "lay" attention recently. It offers such a good look at tissue that its very easy to "over read" the scans. More and more orthopedists are realizing that if there's a good history but not a convincing exam and the MRI is read as there being an injury, often times in surgery there is no appreciable injury.
So, that was a not very nuanced discussion of a side bar. Let me see if I can find the studies about pulley tear diagnosis via u/s vs MRI....
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