- In addition to osseous and articular injuries, MR imag-
ing of the finger can be used to evaluate the integrity of
the extensor and flexor tendons. - In the fingers, disruption of any of the flexor pulleys
can result in bowstringing of the tendon (Parellada
et al, 1996). Detailed MR imaging can demonstrate
the individual flexor pulleys (Hauger et al, 2000) with
the A2 pulley (level of the proximal phalanx) most
commonly injured, often in rock climbers. - Gamekeeper’s thumb, generally seen in skiers, is injury
to the ulnar collateral ligament, with an avulsion frac-
ture at the base of the proximal phalanx, ulnarly
(Campbell, 1955). These injuries are seen to best
advantage on small field of view high-resolution gra-
dientecho MR images, centered over the metacarpal-
phalangeal (MCP) joint. Associated Stener lesions,
which is retracted ulnar collateral ligament fibers
superficial to the adductor pollicis aponeurosis (Stener,
1962), can also be seen with MR imaging as a globular
retracted mass of tissue superficial to the aponeurosis.
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