The cross-sectional area ratio of a specific part of the flexor pollicis longus tendon- a stable sonographic measurement for trigger thumb: a cross-sectional trial

BackgroundTrigger thumb is a pathologic condition of the digital pulleys and flexor tendons. To find a cutoff value of the cross-sectional area ratio of specific parts of the flexor pollicis longus tendon to diagnosis trigger thumb in the high-frequency ultrasound examination.MethodsWe evaluated 271 healthy volunteers and 57 patients with clinical diagnosis of trigger thumb. The cross-sectional area of the metacarpophalangeal joint of flexor pollicis longus tendon (C1) and the cross-sectional area of the midpoint of the first metacarpal of flexor pollicis longus tendon (C2) were analyzed.ResultsThere is no difference between gender, age and left and right hands in the ratio of C1 to C2 (C1/ C2). The mean of C1/ C2 in the healthy thumb was 0.983 +/- 0.103, which was significantly smaller in comparison to the diseased thumb (P < 0.05). Based on the receiver operating characteristic curve, we chose the diagnostic cut-off value for the C1/ C2 to be 1.362 and 1.153 in order to differ a trigger thumb from children and adults.ConclusionsThe C1/ C2 of the healthy thumb was relatively stable, with a mean value of 0.983 +/- 0.103. The cutoff value of C1/C2 to distinguish healthy thumb from diseased thumb in children and adults were 1.362 and 1.153, respectively.

Automated summary

This study aimed to find a cutoff value for diagnosing trigger thumb by analyzing the cross-sectional area ratio of specific parts of the flexor pollicis longus tendon in high-frequency ultrasound examination. 271 healthy volunteers and 57 patients with clinically diagnosed trigger thumb were evaluated. The ratio of C1 to C2 (C1/C2) was analyzed and compared. The mean C1/C2 in healthy thumbs was significantly smaller than in diseased thumbs. The cutoff values of C1/C2 to distinguish healthy thumb from diseased thumb in children and adults were determined.