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Right thumb pain and recurrent locking for the last few months. No history of trauma.
There is a hypoechoic thickening of A1 pulley at the thumb MCP joint. The flexor pollicis longus tendon shows mild thickening with tenosynovitis of the tendon sheath. There is no effusion in the MCP joint. The extensor tendons are normal.
For comparison, asymptomatic thumb shows normal A1 pulley and flexure tendon.
An elderly lady presented with thumb locking for the last few months. Ultrasound findings are consistent with the clinical diagnosis of the trigger thumb.