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Updated: Jun 30, 2026
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A Standardized Acupotomy Protocol For The Treatment of Tenosynovitis of Hand Flexor Tendons In Human Patients
Published on: May 26, 2026
Sonographic appearance of trigger fingers.
Henri Guerini1, Eric Pessis, Nicolas Theumann
1Department of Radiology B, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France. henri.guerini@cch.aphp.fr
Summary
Sonography reveals thickened and hypervascular A1 pulleys in trigger fingers. These findings, along with flexor tendinosis and tenosynovitis, are key indicators of this condition.
Area of Science:
- Musculoskeletal Imaging
- Hand Surgery
- Radiology
Background:
- Trigger finger, or stenosing tenosynovitis, affects the flexor tendons in the hand.
- Accurate diagnosis is crucial for effective treatment planning.
Purpose of the Study:
- To characterize the sonographic features of the first annular (A1) pulley-flexor tendon complex in individuals with trigger fingers.
- To differentiate these features from those in healthy individuals.
Main Methods:
- Ultrasound examination using a 7- to 15-MHz probe was performed on 33 trigger fingers and 20 control hands.
- Systematic measurements of A1 pulley thickness and power Doppler assessments of pulleys, tendons, and tendon sheaths were conducted.
Main Results:
- All trigger fingers exhibited thickened and hypoechoic A1 pulleys, with significantly greater thickness compared to controls (1.8 mm vs. 0.5 mm).
- Hypervascularization of the A1 pulley was observed in 91% of trigger fingers, absent in controls.
- Flexor tendinosis and tenosynovitis were prevalent in trigger fingers (48% and 55%, respectively).
Conclusions:
- A1 pulley thickening and hypervascularization are definitive sonographic markers for trigger fingers.
- Sonography also frequently detects associated distal flexor tendinosis and tenosynovitis in trigger fingers.
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