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Ultrasound Accurately Diagnoses Tendon Injuries

By MedImaging International staff writers
Posted on 25 May 2021

Image: Ultrasound can precisely identify tendon tears in the hand (Photo courtesy of Shutterstock)

Ultrasound can accurately diagnose flexor tendon hand injuries while also being a fast, inexpensive, and potentially indispensable dynamic tool, claims a new study.

Researchers at Ain Shams University (ASU; Cairo, Egypt) conducted a cross-sectional prospective study that included 35 patients (18-58 years of age, 24 male) presenting at ASU between September 2018 and January 2020 with penetrating trauma to the volar aspect of the hand or wrist with questionable clinical findings, and were therefor candidates for exploratory surgery. All underwent pre-operative ultrasound to guide their management, with ultrasound results compared with the operative findings as the gold standard test.

On ultrasound examination, 21 of the 50 injured tendons identifies were reported to have complete tears, and 10 tendons were partially torn. The most common cause of injury was cut wounds by sharp objects (20 cases), with injury by a knife as the highest incidence. The results showed that sonographic examination had 100% accuracy, sensitivity, and specificity, in diagnosing full-thickness tears as well as tenosynovitis of hand flexor tendons. The study was published on April 29, 20201, in Ultrasound in Medicine and Biology.

“Ultrasound provides data on the extent of injury that effectively helps both set up an appropriate operative plan and predict the patient's functional outcome post-operatively, which in turn will have a direct impact on the patient's rehabilitation plan and lifestyle,” concluded lead author Chris Nabil Hanna Bekhet, MD, of the radiodiagnosis department, and colleagues. “Our study also helps anchor the notion that musculoskeletal ultrasound could be widely employed for soft tissue structures, with their well-recognized advantages compared with other imaging techniques.”

Hand and wrist injuries make up 28% of all musculoskeletal injuries and account for 14-30% of all patients treated in the emergency department. Tendon injuries are the second most common of these injuries, with injury to flexor tendons having debilitating consequences and high rates of reoperation. Assessing hand injuries through clinical examination can overlook these tendon injuries, and surgeons sometimes opt for explorative surgical methods to detect them.

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63 (!!!!! 7408.1420898438): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=214 ORDER BY `ordering`

64 (!!!!! 7529.9739837646): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 4686.1171722412): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 7146.1200714111): select jos_google_plus.link from jos_google_plus where cat=10

67 (!!!!! 5134.8209381104): select jos_linkedin.link from jos_linkedin where cat=10

68 (77.962875366211): SELECT fid FROM jos_deeppockets WHERE id=294788375 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294788375 AND published='1' LIMIT 1

69 (46.014785766602): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=214 ORDER BY `ordering`

70 (!!!!! 2737.0452880859): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294788375 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (859.97581481934): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294788375 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (49.829483032227): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (428.91502380371): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (138.0443572998): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (998.97384643555): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (190.01960754395): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (142.09747314453): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (129.93812561035): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (411.03363037109): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294788375 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (133.99124145508): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294788375 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (36.001205444336): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (330.92498779297): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (123.97766113281): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (137.0906829834): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (177.86026000977): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (183.10546875): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (118.97087097168): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (118.01719665527): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (482.08236694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

105 (178.09867858887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

106 (91.075897216797): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294788375 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 1625.0610351562): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294788375 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 1349.925994873): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

109 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

110 (57.93571472168): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294788375 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 1338.9587402344): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294788375 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (680.92346191406): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (488.9965057373): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

115 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

116 (547.17063903809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

117 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

118 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

119 (878.81088256836): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

120 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

121 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

122 (399.11270141602): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 49068.927764893): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (658.03527832031): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294788375 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294788375 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (43.869018554688): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (36.001205444336): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (34.093856811523): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (32.186508178711): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (349.99847412109): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (36.001205444336): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (125.88500976562): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (82.015991210938): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (809.1926574707): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (345.94535827637): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (35.04753112793): SELECT name FROM jos_deeppockets WHERE id=214

138 (111.10305786133): SELECT name FROM jos_deeppockets WHERE id=214

139 (554.80003356934): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (716.9246673584): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (872.13516235352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

142 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

143 (!!!!! 17225.980758667): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 2001.0471343994): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294788375 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (86.069107055664): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294788375 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (437.97492980957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

149 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

150 (!!!!! 1098.1559753418): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

152 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

153 (33.140182495117): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294788375 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294788375 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (30.040740966797): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

155 (55.074691772461): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

156 (30.994415283203): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (114.20249938965): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

158 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788375 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788375 AND published='1' LIMIT 1

159 (36.954879760742): select jos_twitters.link from jos_twitters where cat=10

160 (25.98762512207): select jos_facebook.link from jos_facebook where cat=10

161 (26.941299438477): select jos_google_plus.link from jos_google_plus where cat=10

162 (26.941299438477): select jos_linkedin.link from jos_linkedin where cat=10

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