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Jersey Finger

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Here is a great example of a

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condition called jersey finger.

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And it's not something that

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happens to people from New Jersey.

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It's something that happens typically in

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American football when somebody's

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reaching out to make a tackle and their

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finger gets caught in somebody's jersey.

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And as the person darts away or the hand

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is pulled back, that finger gets caught

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in the jersey and it causes an avulsion

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of the flexor digitorum profundus tendon.

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And what I love about this case is it

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actually shows it at the most commonly

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located area, which is your fourth finger.

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So this is your thumb, one, two, three, four.

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So this is where the abnormality is happening.

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You can see all the fluid within

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the tendon sheath, all the edema.

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That's actually going to be much

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better shown on the sagittal sequences.

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But I just want to go over a little

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bit of anatomy here, which I think

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is very instructive and helpful.

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You see these little paired

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tendons right here?

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That's actually the superficial, uh, flexor

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digitorum superficialis, which comes and

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attaches right here at the middle phalanx.

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And let's look at that on the sagittal images.

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If we look at this right here, so

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here is one coming attaching one side

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here, see that, at the middle phalanx.

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And the other sort of limb of it

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attaching right here also at the

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middle phalanx of the fourth digit.

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So it sort of splits like a forked

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tongue to have two separate attachments.

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Here's the coronal view again.

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These two separate attachments at the

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middle aspect of your middle phalanx.

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Let's look at now.

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The adjacent finger, which is normal.

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So, let's see if we can

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find those structures again.

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And here it is.

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Here are the two paired structures.

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These two structures here, the superficialis,

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flexor digitorum superficialis, correspond

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to these two structures over here.

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But, what's the difference?

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The difference is, on this side, you see

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something else in the middle, extending up.

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Here it is, extending up, and

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attaching to the very distal aspect.

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Or the distal phalanx of that finger.

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Over here, we're not seeing any

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structure between those two structures.

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It's just blank.

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And up here, you're seeing

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sort of this gray something.

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Right?

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It's not black.

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Like this structure is over here.

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It's not black.

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Okay?

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So what's happened?

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Well, this tendon, which is the flexor

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digitorum profundus, and let's show you

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that on the sagittal images over here.

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Okay?

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So, there should be another tendon

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over here, coming to attach at the very

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proximal aspect of your distal phalanx.

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So let's show you a normal side, normal finger.

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Here's a normal finger.

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You see there's a tendon right here.

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You see that thing right here?

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That's the flexor digitorum profundus attaching

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to the volar base of your distal phalanx.

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On our abnormal side, nothing there.

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Maybe a little stubbin of something

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gray, but you sort of lose it.

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So where is that tendon?

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Now, if you look way down here, you see this.

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So that tendon has not only torn, but has

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retracted all the way here to the hand.

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So this is a retracted flexor

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digitorum profundus tendon.

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You can actually see it the best.

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On this sequence, which is the sagittal

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fluid-sensitive fat-suppressed sequence,

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the tendon is bunched up over here.

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Again, this is the superficialis.

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The profundus is torn right at this point.

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And all the stuff, this is fluid

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within the tendon sheath of

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your flexor digitorum profundus.

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So this is a great example of a jersey finger.

Report

Faculty

Mahesh Thapa, MD, MEd, FAAP

Division Chief of Musculoskeletal Imaging, and Director of Diagnostic Imaging Professor

Seattle Children's & University of Washington

Tags

Trauma

Pediatrics

Musculoskeletal (MSK)

MRI

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