Learning objectives
The purpose of our educational exhibit is to:
1.
illustrate the normal anatomy and normal d-HRUS appearance of palmar aponeurosis;
2.
describe a systematic technique for d-HRUS evaluation of such structures;
3.
produce anatomical schemes with didactic purpose and show correlations with sonographic imaging.
Background
The palmar aponeurosis invests muscles and tendons of the palm and consists of central,
lateral and medial bundles.
The apex of central portion triangular in shape continues the lower margin of the transverse carpal ligament.
The base of central bundle divides into four slips,
one for each finger,
with expansion for proximal phalanx bones,
flexor tendon sheaths,
and skin.
The lateral and medial bundles cover the thumb and little finger muscles,
on the radial and the ulnar side,
respectively.
Anatomically the palmar aponeurosis has two...
Findings and procedure details
HRUS represents the first level imaging in the palmar aponeurosis evaluation.
So we will provide a dedicated HR-US images of palmar aponeurosis at different levels, compared with a detailed anatomic scheme,
and a practical guide on “how we do” a HR-US scan.
The patient must be sitting in front of the examiner,
with the upper limb lying on the table and the the palm of the hand facing up (Fig.1).
Place the probe with an axial scan on the proximal wrist,
proximal to carpal tunnel,...
Conclusion
HR-US performed with a very high frequency probe allows a detailed,
real-time evaluation of palmar aponeurosis.
In addition,
dynamic evaluation adds several important information about biomechanics of such superficial structures.
Knowledge of the normal anatomy and imaging appearance of these structures is essential for the depiction of injuries and pathological alteration.
References
Kumar Naveen,
Patil Jyothsn,
Swamy Ravindra ,
Shetty Surekha ,Abhinitha ,
Rao Mohandas ,
Nayak Satheesha case report : presence of multiple tendineous insertions of Palmaris longus : a unique variation of a retrogressive muscle,Ethiop J Health Sci.
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Martinoli C,
Bianchi S,
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Bianchi-Zamorani MP,
Valle M.
Ultrasound of tendons and nerves.
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Natsis Κ,
Didagelos Μ,
Manoli SM,
Vlasis K,Papathanasiou E,
Sofidis G,
Xerantzidou X.Fleshy Palmaris longus muscle- A cadaveric finding and its...