Presentation
Fell off ladder to right hand. Unable to extend first distal interphalangeal joint on the right. Flexion is preserved.
Patient Data
Dynamic ultrasound studies show normal movement of extensor pollicis longus (EPL) tendon for passive flexion and ruptured EPL on the right with 5 mm gap between the thickened ruptured ends.
No fracture or avulsion fracture detected.
Incidental finding of early trapeziometacarpal osteoarthritis.
Case Discussion
Comparing the musculoskeletal ultrasound findings with the contralateral side is a useful tool to avoid pitfalls. Tendon ruptures are not visible on x-ray and tiny avulsion fractures can also be missed on radiographs. Dynamic ultrasound examination might provide further information on the degree of tendon injuries.
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