Diagnosis of digital pulley rupture by computed tomography

Seven patients who presented with a rupture of the digital pulley were investigated by computed tomography. The rupture involved the A2 and A4 pulleys in four cases, the A2 pulley in two cases and, in the final case, the A4 pulley alone. A sagittal-plane CT scan gave a precise analysis of the rupture in all cases. Two cases were surgically repaired and CT scanning was used in their postoperative assessment. When performed by a radiologist with an interest in musculoskeletal pathology, we have found CT scanning to be an excellent imaging procedure in the investigation and diagnosis of digital pulley injury. This can be useful when the diagnosis of digital pulley rupture cannot be made by history and physical examination.