Abstract
Clinical diagnosis of ligament and retinacular injuries of the hand may be challenging.
Ultrasound (US) enables detailed high-resolution, dynamic, and real-time evaluation
of these structures. This article is a comprehensive review of the intricate anatomy,
optimal imaging technique, and normal US appearances of these ligaments and retinacula.
The US features, pertinent biomechanics, clinical presentation, and differential diagnosis
of injuries affecting the annular pulleys, differentiating from climber's finger;
extensor hood including sagittal band and central slip rupture; proximal interphalangeal
and metacarpophalangeal collateral ligaments including the Stener lesion and associated
volar plate injury; and the anterior oblique or beak ligament of the trapeziometacarpal
joint are reviewed. Emphasis is placed on optimal transducer positioning, value of
dynamic US, injury severity, surgical indications, and other US findings with important
management implications. US facilitates a timely accurate diagnosis of hand ligament
and retinacular injury to ensure optimal patient management and minimize the risk
of functional impairment of the hand.
Keywords
ultrasound - hand retinacula - annular pulley - extensor hood - central slip - sagittal
band - collateral ligament - Stener lesion - anterior oblique ligament - beak ligament
