Sonography of a Rupture of the Tendon of the Extensor Pollicis Longus Muscle: Initial Clinical Experience and Correlation with Findings at Cadaveric Dissection
Michel De Maeseneer1,2,3,
Stefaan Marcelis2,
M. Osteaux2,
Tjeerd Jager2,4,
Freddy Machiels5 and
Peter Van Roy3
1 Department of Radiology, Vrije Universiteit Brussel, Laarbeeklaan 101,
Brussels 1090, Belgium.
2 Department of Radiology, Sint-Andries, Tielt, Belgium.
3 Department of Experimental Anatomy, Vrije Universiteit Brussel, Brussels,
Belgium.
4 Present address: Aalsters Stedelijk Zienkenhuis, Alast, Belgium.
5 Department of Radiology, Parc Leopold, Brussels, Belgium.
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Fig. 1. —Photograph of specimen 1 after partial removal of extensor
retinaculum during dissection shows extensor pollicis longus tendon (P) at
intersection with extensor carpi radialis brevis (B) and longus (L) tendons.
Tendon of extensor indicis proprius (i) is seen. On more radial aspect of
wrist, extensor pollicis brevis and abductor pollicis longus tendons
(arrowheads) are shown.
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Fig. 2. —Photograph of transverse slice of specimen 3 at level of
distal radius shows that extensor pollicis longus (EPL) tendon (P) is situated
on ulnar aspect of extensor carpi radialis brevis (B) and longus
(white L) tendons. EPL tendon is seen on top of Lister's tubercle
(black L). Also note extensor digitorum tendon group (D).
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Fig. 3. —Photograph of dissection in specimen 4 shows proximally
(curved arrow) that extensor pollicis longus (EPL) crosses over
extensor carpi radialis tendons. More distally (small black arrows),
EPL reaches base of metacarpal head where it joins extensor pollicis brevis
tendon (arrowheads) and is covered by dorsal reinforcements
(r). EPL tendon (large black arrow) continues distally.
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Fig. 4A. —Sonograms of specimen 3. Transverse sonogram of dorsal aspect
of radius at level of Lister's tubercle (Li) shows that extensor pollicis
longus tendon (calipers) is located on top of Lister's tubercle.
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Fig. 4B. —Sonograms of specimen 3. Sonogram obtained before dissection
in oblique imaging plane extending from Lister's tubercle (L) to base of first
metacarpal shows fibrillar structures of extensor pollicis longus tendon
(arrowheads). Left side of image is caudal; right side, cranial.
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Fig. 5A. —Sonograms of 36-year-old woman with extension deficit of
thumb (patient 2 in Table 1).
Left side of images is proximal; right side, distal. In longitudinal plane,
hypoechoic area with fusiform (R) aspect (between stars) is seen at
normal position of extensor pollicis longus (EPL) tendon.
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Fig. 5B. —Sonograms of 36-year-old woman with extension deficit of
thumb (patient 2 in Table 1).
Left side of images is proximal; right side, distal. In longitudinal plane,
transition zone (asterisk) between rupture (R) and normal fibers
(arrows) is shown at base of first metacarpal bone.
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Fig. 6. —Sonogram in 37-year-old man with extension deficit of thumb
(patient 3 in Table 1).
Longitudinal view of extensor pollicis longus (EPL) shows empty tendon sheath
of EPL (r). Area of rupture (between stars) is indicated. Deep in
relation to ruptured EPL tendon, extensor carpi radialis tendon (e) is shown.
Left side is proximal; right side, distal.
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Copyright © 2005 by the American Roentgen Ray Society.
