Bandverletzungen am Daumen und an den Fingern

[Bony and ligamentous injuries of the thumb ray]

Fractures and ligamentous lesions of the thumb ray are frequent due to the exposed position of the thumb. A thorough anatomical understanding with respect to the joints and stabilizing ligaments is essential for a targeted examination, the selection of appropriate imaging diagnostics and the decision for a surgical or conservative treatment approach. Misdiagnoses or untreated injuries can lead to impaired functionality, pain and instability, which can substantially impair the function of the hand, particularly thumb opposition.

MRI Diagnostics of the Fingers: Current Developments and Clinical Relevance

Magnetic resonance imaging (MRI) is an excellent method for visualizing the complex anatomical structures of the fingers. The high diagnostic standard is based on numerous recent technical developments to improve soft tissue differentiation and detail recognition, and includes time-resolved functional imagingThis review highlights the current status of MRI in finger diagnostics. The content of this narrative review is based on a literature search in the PubMed and Google Scholar databases using the search terms "finger MRI" and "finger imaging".Due to numerous technical optimizations and the increasing clinical availability of MRI, this examination has become indispensable in routine use for the further clarification of traumatic and orthopedic clinical pictures. MRI is also playing an increasingly important role in rheumatic and inflammatory issues, as well as tumors, whereby the particularly high potential for early detection and the detailed soft tissue imaging are especially advantageous. · MRI enables precise differential diagnosis of all clinical pictures of the fingers and is useful in the clarification of traumatic, orthopedic, rheumatic, inflammatory, and neoplastic issues.. · Multi-channel hand coils, scanners with high magnetic field strengths, and the use of contrast agents have led to an evaluation with resolutions in the submillimeter range in some cases.. · High-resolution MRI, including the possibility of functional examination, makes it easier to determine adequate therapy and avoid subsequent damage while meeting high standards.. · Bayer T, Lutter C, Janka R et al. MRI Diagnostics of the Fingers: Current Developments and Clinical Relevance. Rofo 2025; DOI 10.1055/a-2594-7451.

Trapeziometacarpal joint imaging: Normal high-resolution MRI, US and CT compared with cadaveric specimens and pathological imaging findings

INTRODUCTION

The trapeziometacarpal (TMC) joint is a complex joint, whose anatomy and function are different from the metacarpophalangeal joints of the long fingers. The stability of this joint is ensured at three levels by multiple structures: osteochondral, capsulo-ligamentous, and musculo-tendinous. The anatomical and biomechanical structures ensuring the stability of the TMC joint are perfectly evaluated on magnetic resonance imaging (MRI), with a high degree of confidence. All described ligaments are anatomically visible and perfectly assessed on MRI and ultrasound (US): the dorsoradial ligament, the posterior oblique ligament, the intermetacarpal ligament, the ulnar collateral ligament, the two bundles of the anterior oblique ligament (break ligament), as well as the superficial anterior oblique and deep anterior oblique ligaments.

METHODOLOGY

This educational review assesses the TMC joint anatomy using high-field MRI and US compared with cadaveric specimens as well the biomechanics of this joint. In addition, it highlights pathological patterns of traumatic (sprain, dislocation, and fractures) and degenerative diseases.

RESULTS AND CONCLUSION

Knowledge of TMC joint anatomy is crucial to the radiologists' understanding and assessment of various traumatic and degenerative pathologies, and thus helps clinicians and surgeons choose the appropriate treatment.

[Sports-related injuries of the thumb and fingers]

Finger and thumb injuries are common in established and trend sports. Imaging plays an important role in acute trauma care, further therapy planning, and ultimately for a rapid return to play. Sound knowledge of the complex anatomy of the fingers and thumb is indispensable for accurate diagnosis. This article presents the ligament anatomy of the metacarpophalangeal and interphalangeal joints of the finger and the thumb, the extensor and flexor tendon apparatus, and the diagnosis of typical sports injuries using x‑rays and magnetic resonance imaging. Furthermore, imaging findings of typical sports-associated injuries are illustrated.

Injuries to the Collateral Ligaments of the Metacarpophalangeal and Interphalangeal Joints: Sonographic Appearance

Injuries to the collateral ligaments of the metacarpophalangeal (MCP) and interphalangeal (IP) joints are commonly encountered in both athletes and nonathletes. They require prompt evaluation to ensure proper management and prevent loss of joint motion and permanent disability. Imaging is often required to confirm the diagnosis and assess injury severity. This review article aims to provide physicians with guidelines for sonographic assessment of the collateral ligaments of the MCP and IP and related injuries. Sonographic features of ligament injuries ranging from sprains and partial-thickness tears to full-thickness tears are described. Specific lesions of the ulnar collateral ligament of the thumb MCP joint, such as gamekeeper's thumb, skier's thumb, and Stener lesions, are also included. In conclusion, sonography is effective in evaluating the collateral ligaments of the MCP and IP joints and related injuries and represents a valuable tool for diagnosis.

[Ligamentous lesions and instability of the finger joints]

Joint capsule and ligamentous lesions are common injuries of the upper extremities. Athletes are particularly inclined to suffer from these injuries. Clinical and radiological examinations are the cornerstone of an adequate treatment. Ultrasound-based diagnostics as a non-invasive and dynamic investigation method are gaining increasing relevance based on the development of high resolution probes. A correct interpretation of the findings is only feasible with a comprehensive knowledge of the anatomy. The most important goal is stability as a prerequisite for early active and passive motion with unrestricted range of motion.