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Annular pulley partial tear - thumb

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Inability to flexion of thumb proximal phalanx.

Patient Data

Age: 35 years
Gender: Male
This study is a stack
Axial PD
fat sat
This study is a stack
Sagittal
PD fat sat
This study is a stack
Coronal PD
fat sat
This study is a stack
Coronal
T1
This study is a stack
Coronal
T2
This study is a stack
Axial
T2
This study is a stack
Axial
T1
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Info

Edema and thickening along the ulnar side of the pulley and edema between the flexor pollicis longus tendon and the thumb proximal phalanx are redemonstrated. The appearance in this patient is compatible with annular pulley partial tear.

There is also bone marrow edema/contusion at the head of the first metacarpal bone.

Case Discussion

In acute mild pulley injury or partial tear, edema is seen along the course of the involved pulley in the sagittal view and pulley edema or irregularity may be directly visualized on the axial plan.

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