![]() With the rise in popularity of the sport of rock climbing in the 1980’s, closed finger pulley ruptures began to appear. On sagittal images, the next most useful images to evaluate for pulley injuries, the flexor tendons should be 1mm or less away from their adjacent phalanges. Arrowheads depict annular pulleys in cross section Cruciform pulleys are only rarely visualized on imaging due to their extremely small size.įig 3. #1 and #4 will be covered in this article.Īnnular and pulleys are arranged as in Fig 1, and are thin markedly hypointense structures on MR imaging connecting the flexor tendons to the phalanges and joints, best directly visualized on axial images. A2 pulley injuries have also been described in bowlers (Patel 2012). Baseball pitchers were shown in a small series to suffer isolated middle finger A4 injuries, thought to be related to repetitive ball-induced extension moments on an acutely flexed DIP joint when throwing fastballs (Lourie 2011). Rock climbers typically injure distal aspect of the A2 pulley, with involvement of A3 and A4 in more severe injuries, related to crimping posture (DIP hyperextension and PIP hyperflexion). classically with rock climbing, but more recently shown in baseball pitchers too (Lourie 2010). Overuse or stress ruptures of the annular pulleys, e.g. ![]()
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