Flexor Digitorum Superficialis and Flexor Digitorum Profundus with separated sheaths, a new normal variation in human / Flexor superficial de la y Flexor profundo de los con vainas separadas, una nueva variación normal en humanos

Case description: A 25 years old man presented with a laceration on radial side of proximal phalanx of 4th finger (zone II flexor) which was due to cut with glass. Clinical findings: The sheaths of Tendons of flexor digitorum sperficialis and profundus were not the same and each tendon had a separate sheath. Treatment and outcome: The tendons were reconstructed by modified Kessler sutures, after 15 months the patient had a 30 degrees of extension lag even after physiotherapy courses. Clinical relevance: This is the first reported of such normal variation in human hand tendon anatomy.

Descripción del caso: Se presentó un hombre de 25 años con una laceración en la parte radial de la falange proximal del cuarto dedo de la mano (zona flexor II) causada por el corte con un vidrio. Hallazgos clínicos: Las cubiertas de los tendones del flexor digitorum sperficialis y profundus estaban separadas en diferentes cubiertas. Tratamiento y resultado: Los tendones se reconstruyeron por la suturas modificadas de Kessler. Después de 15 meses el paciente presentó una pérdida del 30% en la extensión , aun después de la fisioterapia. Relevancia clínica: Es el primer reporte de la variación en la anatomía de la mano.

The study of dual energy spectral CT on the image quality of hand tendons / 实用放射学杂志

Objective To evaluate the image quality of hand tendons by using spectral CT,compared with conventional CT ima-ges.Methods Forty patients scanned with spectral CT were enrolled.The 65keV of optimal contrast-to-noise ratio (Optimal CNR) for viewing hand tendons was selected.The image quality of monochromatic GSI images (65 keV)and conventional CT images were compared with two different methods including subjective method and objective method by two radiologists respectively.Results In subjective method,the image quality in GSI images was superior to conventional CT images (P <0.05).And in objective method, the beam-hardening artifacts in the phalanges of fingers space were reduced markedly with hand tendons displaying more clearly in GSI images (P <0.05 ).There was no significant difference between the two radiologists in both methods with good correlation (Kappa=0.75,Kappa=0.85).Conclusion Spectral CT with the optimal 65keV monochromatic images could reduce the artifacts and increase image quality significantly in hand tendons imaging.It might be a very useful supplementary imaging method in detec-ting tendon diseases in routine work.