{"id":305,"date":"2018-07-01t12:13:10","date_gmt":"2018-07-01t02:13:10","guid":{"rendered":"\/\/www.iolishoes.com\/?page_id=305"},"modified":"2024-01-22t17:58:41","modified_gmt":"2024-01-22t06:58:41","slug":"hand-finger-normal","status":"publish","type":"page","link":"\/\/www.iolishoes.com\/hand-finger-normal\/","title":{"rendered":"hand-finger normal"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"305\" class=\"elementor elementor-305\" data-elementor-post-type=\"page\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-753cea5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"753cea5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5e1ae7c\" data-id=\"5e1ae7c\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-ea31cfe elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"ea31cfe\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-2d18cc93\" data-id=\"2d18cc93\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-71daa57b elementor-align-right elementor-widget elementor-widget-button\" data-id=\"71daa57b\" data-element_type=\"widget\" data-widget_type=\"button.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"elementor-button-wrapper\">\n\t\t\t\t\t<a class=\"elementor-button elementor-button-link elementor-size-sm elementor-animation-grow\" href=\"\/\/www.iolishoes.com\/pathology-handfinger\/?r=579e2ccb09b8e3acf8a83c02b3f8a056\">\n\t\t\t\t\t\t<span class=\"elementor-button-content-wrapper\">\n\t\t\t\t\t\t<span class=\"elementor-button-icon\">\n\t\t\t\t\t\t\t\t\t<i class=\"fa fa-arrow-circle-o-down\" aria-hidden=\"true\"><\/i>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-button-text\">click here<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t<\/a>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-6a7ce4e1\" data-id=\"6a7ce4e1\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4e7ec94e elementor-widget elementor-widget-text-editor\" data-id=\"4e7ec94e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>for images of pathology, and detailed descriptions.<\/strong><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4f9979e6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4f9979e6\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2315fa0f\" data-id=\"2315fa0f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-27143872 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"27143872\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-84c29d9 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"84c29d9\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-56c7085\" data-id=\"56c7085\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d34b671 elementor-widget elementor-widget-heading\" data-id=\"d34b671\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"palmar_aspect\"><\/span>palmar aspect <span class=\"ez-toc-section-end\"><\/span><\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-512b4fd elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"512b4fd\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-91df615\" data-id=\"91df615\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6d5d935 elementor-widget elementor-widget-text-editor\" data-id=\"6d5d935\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>the primary structures to examine are:<\/strong><\/p><ul><li>flexor tendons and sheaths.<\/li><li>joints<\/li><li>pulleys<\/li><li>volar plates<\/li><li>neuro-vascular bundles<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-83a69af\" data-id=\"83a69af\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-a512d89 elementor-widget elementor-widget-image\" data-id=\"a512d89\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-anatomy-palmar.jpg\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"anatomy of the anterior\/palmar aspect of the hand.\nref: anatomylearning.com\" data-e-action-hash=\"#elementor-action%3aaction%3dlightbox%26settings%3deyjpzci6mtm0njysinvybci6imh0dhbzolwvxc91bhryyxnvdw5kcgflzglhlmnvbvwvd3aty29udgvudfwvdxbsb2fkc1wvmjaymfwvmtjcl2hhbmqtyw5hdg9tes1wywxtyxiuanbnin0%3d\">\n\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"914\" height=\"729\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-anatomy-palmar.jpg\" class=\"attachment-large size-large wp-image-13466\" alt=\"anatomy of the anterior hand\" srcset=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-anatomy-palmar.jpg 914w, \/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-anatomy-palmar-300x239.jpg 300w, \/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-anatomy-palmar-768x613.jpg 768w\" sizes=\"(max-width: 914px) 100vw, 914px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c0d2eed elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c0d2eed\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-262c19f\" data-id=\"262c19f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-31efc7a elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"31efc7a\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5cdcfc2d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5cdcfc2d\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1bfcab5f\" data-id=\"1bfcab5f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-64d136a elementor-widget elementor-widget-heading\" data-id=\"64d136a\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"flexor_tendons\"><\/span>flexor  tendons<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-34de0186 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"34de0186\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1ae610f3\" data-id=\"1ae610f3\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7fe185a7 elementor-widget elementor-widget-pp-advanced-accordion\" data-id=\"7fe185a7\" data-element_type=\"widget\" data-settings=\"{&quot;accordion_type&quot;:&quot;toggle&quot;,&quot;toggle_speed&quot;:300}\" data-widget_type=\"pp-advanced-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"pp-advanced-accordion pp-toggle-icon-align-right\" id=\"pp-advanced-accordion-7fe185a7\" data-accordion-id=\"7fe185a7\" role=\"tablist\">\n\t\t\t\t\t\t\t<div class=\"pp-accordion-item\">\n\t\t\t\t\t\t\t\t\t\t<div id=\"pp-accordion-tab-title-2141\" class=\"pp-accordion-tab-title\" tabindex=\"0\" data-tab=\"1\" role=\"tab\" aria-controls=\"pp-accordion-tab-content-2141\" aria-expanded=\"false\">\n\t\t\t\t\t\t<span class=\"pp-accordion-title-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-accordion-title-text\">\n\t\t\t\t\t\t\t\tanatomy\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-accordion-toggle-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-close pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-down\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-open pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-up\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"pp-accordion-tab-content-2141\" class=\"pp-accordion-tab-content\" data-tab=\"1\" role=\"tabpanel\" aria-labelledby=\"pp-accordion-tab-title-2141\">\n\t\t\t\t\t\t<h4><span class=\"ez-toc-section\" id=\"thumb\"><\/span><span style=\"font-size: 14pt;\">thumb:<\/span><span class=\"ez-toc-section-end\"><\/span><\/h4><ul><li><span style=\"text-decoration: underline;\"><strong>pulleys:<\/strong><\/span> 2 annular pulleys and an oblique pulley (which arises from the aponeurosis of the adductor pollicis muscle (thenar eminence)<\/li><li><span style=\"text-decoration: underline;\"><strong>tendons:<\/strong><\/span> flexor pollicis longus(fpl) runs through the carpal tunnel and thenar eminence to insert on the distal phalanx. flexor pollicis brevis forms the thenar eminence of the hand.<\/li><\/ul><figure id=\"attachment_13495\" aria-describedby=\"caption-attachment-13495\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/thumb-flexor-anatomy2-labelled.jpg\"><img decoding=\"async\" class=\"wp-image-13495 size-medium\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/thumb-flexor-anatomy2-labelled-300x181.jpg\" alt=\"thumb flexor anatomy labelled\" width=\"300\" height=\"181\" srcset=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/thumb-flexor-anatomy2-labelled-300x181.jpg 300w, \/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/thumb-flexor-anatomy2-labelled-768x465.jpg 768w, \/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/thumb-flexor-anatomy2-labelled.jpg 815w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-13495\" class=\"wp-caption-text\">thumb flexor anatomy labelled. ref www.anatomylearning.com<\/figcaption><\/figure><h4><span class=\"ez-toc-section\" id=\"fingers\"><\/span><span style=\"font-size: 14pt;\">fingers:<\/span><span class=\"ez-toc-section-end\"><\/span><\/h4><ul><li><span style=\"text-decoration: underline;\"><strong>tendons:<\/strong><\/span> there are 2 primary flexor tendons of the 4 fingers:<\/li><\/ul><ol><li>flexor digitorum superficialis tendon(fds). this lies most superficial at the level of the metacarpal. it divides into 2 slips, each circling under the fdp tendon to insert as 2 separate slips onto the base of the middle phalanx. (function: flex the pipj)<\/li><li>flexor digitorum profundus tendon (fdp) is deep to the fds. the fdp inserts onto the base of the distal phalanx. (function: flex the dipj)<\/li><\/ol><ul><li><span style=\"text-decoration: underline;\"><strong>pulleys:<\/strong><\/span> role is to support and guide\u00a0 the flexor tendons along the bone.<\/li><\/ul><p>5 annular pulleys (a1-5) and 3 cruciate pulleys (c1-3). the cruciate pulleys are poorly seen on ultrasound due to anisotrophy.<\/p><table style=\"border-collapse: collapse; width: 100.725%; height: 352px;\"><tbody><tr><td style=\"width: 42.029%;\"><figure id=\"attachment_13530\" aria-describedby=\"caption-attachment-13530\" style=\"width: 269px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" class=\"size-medium wp-image-13530\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/finger-tendon-antomy-labelled-269x300.jpg\" alt=\"anatomy of the flexor tendons of the fingers labelled\" width=\"269\" height=\"300\" srcset=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/finger-tendon-antomy-labelled-269x300.jpg 269w, \/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/finger-tendon-antomy-labelled.jpg 601w\" sizes=\"(max-width: 269px) 100vw, 269px\" \/><figcaption id=\"caption-attachment-13530\" class=\"wp-caption-text\">anatomy of the flexor tendons of the fingers labelled<\/figcaption><\/figure><\/td><td style=\"width: 57.971%;\"><figure id=\"attachment_13532\" aria-describedby=\"caption-attachment-13532\" style=\"width: 274px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-13532\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/finger-pulley-anatomy-labelled-274x300.jpg\" alt=\"anatomy of the finger pulleys labelled\" width=\"274\" height=\"300\" srcset=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/finger-pulley-anatomy-labelled-274x300.jpg 274w, \/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/finger-pulley-anatomy-labelled.jpg 563w\" sizes=\"(max-width: 274px) 100vw, 274px\" \/><figcaption id=\"caption-attachment-13532\" class=\"wp-caption-text\">anatomy of the finger pulleys a1-5 and c1-3 labelled.<\/figcaption><\/figure><\/td><\/tr><\/tbody><\/table>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"pp-accordion-item\">\n\t\t\t\t\t\t\t\t\t\t<div id=\"pp-accordion-tab-title-2142\" class=\"pp-accordion-tab-title\" tabindex=\"0\" data-tab=\"2\" role=\"tab\" aria-controls=\"pp-accordion-tab-content-2142\" aria-expanded=\"false\">\n\t\t\t\t\t\t<span class=\"pp-accordion-title-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-accordion-title-text\">\n\t\t\t\t\t\t\t\tpatient position\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-accordion-toggle-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-close pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-down\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-open pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-up\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"pp-accordion-tab-content-2142\" class=\"pp-accordion-tab-content\" data-tab=\"2\" role=\"tabpanel\" aria-labelledby=\"pp-accordion-tab-title-2142\">\n\t\t\t\t\t\t<p><span style=\"color: #003366;\">to scan the hand and fingers:<\/span><\/p><ul><li>patient seated comfortably.<\/li><li>on the edge of the bed with their hand on a pillow on their lap, or seated on a chair on the opposite side of the bed with their arm outstretched towards you.<\/li><li>hand supported on a towel or similar.<\/li><\/ul><p>tip: you will need the ability to flex\/extend the fingers so ensure nothing obstructs this.<\/p>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"pp-accordion-item\">\n\t\t\t\t\t\t\t\t\t\t<div id=\"pp-accordion-tab-title-2143\" class=\"pp-accordion-tab-title\" tabindex=\"0\" data-tab=\"3\" role=\"tab\" aria-controls=\"pp-accordion-tab-content-2143\" aria-expanded=\"false\">\n\t\t\t\t\t\t<span class=\"pp-accordion-title-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-accordion-title-text\">\n\t\t\t\t\t\t\t\ttechnique\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-accordion-toggle-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-close pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-down\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-open pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-up\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"pp-accordion-tab-content-2143\" class=\"pp-accordion-tab-content\" data-tab=\"3\" role=\"tabpanel\" aria-labelledby=\"pp-accordion-tab-title-2143\">\n\t\t\t\t\t\t<p><span style=\"color: #003366;\">to examine the flexor tendons of the finger:<\/span><\/p><ol><li>place the transducer transversely across the palm of the hand just proximal to the base of the finger crease<\/li><li>slide the probe distally in transverse following the tendons. fds to the base of the middle phalanx and fdp to the distal phalanx.<\/li><li>rotate into longitudinal.<\/li><li>confirm the distal fdp insertion.\u00a0<\/li><li>follow proximally in longitudinal to the palm.<\/li><li>dynamically assess the tendons sliding. particularly under the a1 and a2 pulleys<\/li><li>examine the insertions of the fds slips. from longitudinal over the midline of the base of the proximal phalanx, rotate the distal end of the probe slightly to the side so you are oblique. repeat for both radial and ulnar slips.<\/li><\/ol><p>tips:<\/p><ul><li>at the proximal phalanx, fds will divide and rotate to be deep to the fdp.<\/li><li>the tendon sheath begins approximately at the mid metacarpal and extends to the distal phalanx.<\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"pp-accordion-item\">\n\t\t\t\t\t\t\t\t\t\t<div id=\"pp-accordion-tab-title-2144\" class=\"pp-accordion-tab-title\" tabindex=\"0\" data-tab=\"4\" role=\"tab\" aria-controls=\"pp-accordion-tab-content-2144\" aria-expanded=\"false\">\n\t\t\t\t\t\t<span class=\"pp-accordion-title-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-accordion-title-text\">\n\t\t\t\t\t\t\t\tnormal appearances\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-accordion-toggle-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-close pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-down\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-open pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-up\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"pp-accordion-tab-content-2144\" class=\"pp-accordion-tab-content\" data-tab=\"4\" role=\"tabpanel\" aria-labelledby=\"pp-accordion-tab-title-2144\">\n\t\t\t\t\t\t<p><span style=\"color: #003366;\">normal appearance of the flexor tendons:<\/span><\/p><ol><li>transverse: echogenic and ovoid<\/li><li>longitudinal: echogenic and fibrillar.<\/li><li>size: fds smaller than fdp<\/li><li>no fluid should be visible.<\/li><li>fds divides into 2 slips at the proximal phalanx. each slip equal in size and coursing around the side, then under the fdp.<\/li><li>dynamics: the tendons should glide freely with finger flexion\/extension.<\/li><\/ol><p>tips:<\/p><ul><li>once at the level of the mid palm crease, it is common and normal to observe tendon bunching.<\/li><li>once fds has divided, there will be anisotrophy of fds relative to fdp in the transverse plane. (ie one hypoechoic, when one is echogenic)<\/li><li>fdp should sit against the proximal 1\/3 of each phalanx. if not, suspect a pulley injury.<\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"pp-accordion-item\">\n\t\t\t\t\t\t\t\t\t\t<div id=\"pp-accordion-tab-title-2145\" class=\"pp-accordion-tab-title\" tabindex=\"0\" data-tab=\"5\" role=\"tab\" aria-controls=\"pp-accordion-tab-content-2145\" aria-expanded=\"false\">\n\t\t\t\t\t\t<span class=\"pp-accordion-title-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-accordion-title-text\">\n\t\t\t\t\t\t\t\twhat to look for?\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-accordion-toggle-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-close pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-down\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-open pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-up\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"pp-accordion-tab-content-2145\" class=\"pp-accordion-tab-content\" data-tab=\"5\" role=\"tabpanel\" aria-labelledby=\"pp-accordion-tab-title-2145\">\n\t\t\t\t\t\t<p><span style=\"color: #003366;\">once you identify the flexor tendons of the finger:<\/span><\/p><ol><li>are they\u00a0 fibrillar and homogeneous?<\/li><li>do the gradually decrease in size distally?<\/li><li>there should be no fluid visible in the sheath.<\/li><li>do they slide freely?<\/li><li>is fdp against the proximal 1\/3 of each phalanx?<\/li><\/ol>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2427cadb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2427cadb\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-7b130b2f\" data-id=\"7b130b2f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1b9d71a5 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"1b9d71a5\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-96cb2ae elementor-widget elementor-widget-text-editor\" data-id=\"96cb2ae\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>scan plane for the flexor digitorum tendons.<\/p><p>the profundus and superficialis.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-66e7ca80\" data-id=\"66e7ca80\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-78cc0836 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"78cc0836\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-15e0488e elementor-widget elementor-widget-text-editor\" data-id=\"15e0488e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound of normal flexor digitorum superficialis tendon (fds) and flexor digitorum profundus tendon(fdp) at the level of the metacarpal neck.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-473f5f35 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"473f5f35\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-64864352\" data-id=\"64864352\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2e82d237 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"2e82d237\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0b3a2a7 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"0b3a2a7\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-11aa77e\" data-id=\"11aa77e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-66f1c491 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"66f1c491\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0a7b3b7 elementor-widget elementor-widget-text-editor\" data-id=\"0a7b3b7\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>scan plane for the flexor digitorum tendons in transverse prior to the separation of superficialis from profundus.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-7f4cd9a\" data-id=\"7f4cd9a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3f972dde elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"3f972dde\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1e3d3cb elementor-widget elementor-widget-text-editor\" data-id=\"1e3d3cb\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound of the flexor digitorum superficialis tendon slips (green).<\/p><p>the fds division be seen peeling off the underlying flexor digitorum profundus tendon (blue).<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2d819171 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2d819171\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-4fa8c8e7\" data-id=\"4fa8c8e7\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-507d920a elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"507d920a\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-08a012a elementor-widget elementor-widget-text-editor\" data-id=\"08a012a\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>scan plane for the flexor digitorum tendon at the a4 pulley, distal to the superficialis insertions.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-49b7c2d0\" data-id=\"49b7c2d0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3560a69a elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"3560a69a\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5fa94d9 elementor-widget elementor-widget-text-editor\" data-id=\"5fa94d9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound of flexor digitorum profundus tendon in transverse.<\/p><p>the neurovascular bundles are circled in red.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-61409c28 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"61409c28\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-70e68634\" data-id=\"70e68634\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3612344f elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"3612344f\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3701ebf elementor-widget elementor-widget-text-editor\" data-id=\"3701ebf\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>scan plane for the flexor digitorum profundus insertion.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-456024ff\" data-id=\"456024ff\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2bde88f8 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"2bde88f8\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a177415 elementor-widget elementor-widget-text-editor\" data-id=\"a177415\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound of the flexor digitorum profundus insertion onto the distal phalanx.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-eb069c1 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"eb069c1\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-bf97272\" data-id=\"bf97272\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b77637c elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"b77637c\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-449c5bc elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"449c5bc\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b6746a5\" data-id=\"b6746a5\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-d18a024 elementor-widget elementor-widget-heading\" data-id=\"d18a024\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"pulleys\"><\/span>pulleys<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-353dfea elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"353dfea\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-128cc00\" data-id=\"128cc00\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-b1f5852 elementor-widget elementor-widget-text-editor\" data-id=\"b1f5852\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>anatomy<\/strong><\/p><p>the flexor tendons are secured in place by a series of pulleys which are fibrous bands wrapping over the tendons and attaching to the bone.<\/p><p>annular pulleys: which wrap transversely over the tendons. numbered a1 &#8211; a4 (see below).<br \/>cruciate pulleys: which are paired and cross diagonally over the tendons. numbered c1 &#8211; c3. (see below).<br \/>the annular pulleys are readily visible with high resolution, high quality equipment. the cruciate pulleys are poorly seen.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-237a2de7 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"237a2de7\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-42ab91f4\" data-id=\"42ab91f4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-626cbfb1 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"626cbfb1\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-e791c5f elementor-widget elementor-widget-text-editor\" data-id=\"e791c5f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>anatomy specimen showing the annular pulleys with the finger extended. the 2 fds slips are visible emerging from the a2 pulley, beside the fdp tendon. courtesy of dr andreas schweizer.<\/p><p><a href=\"http:\/\/www.turntillburn.ch\" target=\"_blank\" rel=\"noopener\">www.turntillburn.ch<\/a><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-3fb9a9f1\" data-id=\"3fb9a9f1\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-ad4d483 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"ad4d483\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3a9310e elementor-widget elementor-widget-text-editor\" data-id=\"3a9310e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>anatomy specimen showing the annular pulleys with the finger flexed. fdp has been elevated, the thin fds slip can be seen underneath the elevator. courtesy of dr andreas schweizer.<\/p><p><a href=\"http:\/\/www.turntillburn.ch\" target=\"_blank\" rel=\"noopener\">www.turntillburn.ch<\/a><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-64945cd4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"64945cd4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-bd723d\" data-id=\"bd723d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-23995d67 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"23995d67\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-16147c3 elementor-widget elementor-widget-text-editor\" data-id=\"16147c3\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>scan plane a2 pulley. longitudinal.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-429ce0e1\" data-id=\"429ce0e1\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7acb5343 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"7acb5343\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-abd330f elementor-widget elementor-widget-text-editor\" data-id=\"abd330f\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound of a2 pulley at the proximal phalanx.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-6527f64 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"6527f64\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-27396672\" data-id=\"27396672\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4640ac32 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"4640ac32\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-64dc131 elementor-widget elementor-widget-text-editor\" data-id=\"64dc131\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>scan plane for the a2 pulley in transverse.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-6a71135b\" data-id=\"6a71135b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-16605a56 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"16605a56\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b8d29ed elementor-widget elementor-widget-text-editor\" data-id=\"b8d29ed\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound transverse view of the a2 pulley (green) firmly overlying the flexor digitorum tendon at the mid proximal phalanx.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-72df7f2b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"72df7f2b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-45ebca25\" data-id=\"45ebca25\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3f659bc8 elementor-grid-2 elementor-grid-tablet-2 elementor-grid-mobile-1 pp-video-gallery-content-below-video elementor-widget elementor-widget-pp-video-gallery\" data-id=\"3f659bc8\" data-element_type=\"widget\" data-settings=\"{&quot;layout&quot;:&quot;grid&quot;}\" data-widget_type=\"pp-video-gallery.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"pp-video-gallery-container pp-video-gallery-grid\">\n\t\t\t<div class=\"pp-video-gallery-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"pp-video-gallery elementor-grid\" data-action=\"lightbox\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-3f659bc8\" href=\"https:\/\/vimeo.com\/489187851\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/1012070192-d33f4af48559656e7591d28a39ea6f302ec78463953a195f709f77d1dbe6d5d5-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tflexor digitorum tendons at a1 pulley\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\tlongitudinal view observing smooth sliding of the flexor tendons at the a1 pulley during finger flexion\/extension.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-3f659bc8\" href=\"https:\/\/vimeo.com\/489221848\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/1012128231-bf23b9e3433d9e471d8d45ea7d9d179f9fc683ef26e720ebc9f5ef82e7cb2017-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\tflexor digitorum tendons at the a2 pulley\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\tultrasound of the flexor digitorum tendons sliding normally under the a2 pulley. to observe this, passively flex\/extend the distal interphalangeal joint (finger-tip).\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-e25359f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"e25359f\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a8afa33\" data-id=\"a8afa33\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-244f16d elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"244f16d\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c91026b elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c91026b\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-ba7084b\" data-id=\"ba7084b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-77d4496 elementor-widget elementor-widget-heading\" data-id=\"77d4496\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"palmar_fascia\"><\/span>palmar fascia<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-4806fca4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"4806fca4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-71a6f19b\" data-id=\"71a6f19b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-65322a75 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"65322a75\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5b8091c elementor-widget elementor-widget-text-editor\" data-id=\"5b8091c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>scan plane when assessing for the palmar fascia<\/p><p>(eg for dupuytren&#8217;s contracture)<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-6a376dda\" data-id=\"6a376dda\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4caa9dec elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"4caa9dec\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6ceb4e1 elementor-widget elementor-widget-text-editor\" data-id=\"6ceb4e1\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound of normal palmar fascia (green) at the level of the mcpj.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1b937c0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1b937c0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b009b75\" data-id=\"b009b75\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-38769f2 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"38769f2\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1d3bad3 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1d3bad3\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-177f865\" data-id=\"177f865\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-f75915d elementor-widget elementor-widget-heading\" data-id=\"f75915d\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h2 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"dorsal_aspect\"><\/span>dorsal aspect <span class=\"ez-toc-section-end\"><\/span><\/h2>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-3ee751d elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"3ee751d\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-1488857\" data-id=\"1488857\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9647377 elementor-widget elementor-widget-text-editor\" data-id=\"9647377\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>the primary dorsal structures to examine are:<\/strong><\/p><ul><li>extensor tendons and sheaths.<\/li><li>extensor hood<\/li><li>joints<\/li><li>nail bed<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-00072b0\" data-id=\"00072b0\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6472cbe elementor-widget elementor-widget-image\" data-id=\"6472cbe\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-finger-extensor-tendon-anatomy-labelled.jpg\" data-elementor-open-lightbox=\"yes\" data-elementor-lightbox-title=\"anatomy of the hand &amp; finger extensor tendons.\" data-e-action-hash=\"#elementor-action%3aaction%3dlightbox%26settings%3deyjpzci6mtq3mzisinvybci6imh0dhbzolwvxc91bhryyxnvdw5kcgflzglhlmnvbvwvd3aty29udgvudfwvdxbsb2fkc1wvmjaymfwvmtjcl2hhbmqtzmluz2vylwv4dgvuc29ylxrlbmrvbi1hbmf0b215lwxhymvsbgvklmpwzyj9\">\n\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"657\" height=\"668\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-finger-extensor-tendon-anatomy-labelled.jpg\" class=\"attachment-large size-large wp-image-14732\" alt=\"hand finger extensor tendon anatomy labelled\" srcset=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-finger-extensor-tendon-anatomy-labelled.jpg 657w, \/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-finger-extensor-tendon-anatomy-labelled-295x300.jpg 295w\" sizes=\"(max-width: 657px) 100vw, 657px\" \/>\t\t\t\t\t\t\t\t<\/a>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-419957f3 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"419957f3\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-6e6e568b\" data-id=\"6e6e568b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4adccbd2 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"4adccbd2\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-41048f0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"41048f0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-fce9a0b\" data-id=\"fce9a0b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-17fabd5 elementor-widget elementor-widget-pp-advanced-accordion\" data-id=\"17fabd5\" data-element_type=\"widget\" data-settings=\"{&quot;accordion_type&quot;:&quot;toggle&quot;,&quot;toggle_speed&quot;:300}\" data-widget_type=\"pp-advanced-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"pp-advanced-accordion pp-toggle-icon-align-right\" id=\"pp-advanced-accordion-17fabd5\" data-accordion-id=\"17fabd5\" role=\"tablist\">\n\t\t\t\t\t\t\t<div class=\"pp-accordion-item\">\n\t\t\t\t\t\t\t\t\t\t<div id=\"pp-accordion-tab-title-2511\" class=\"pp-accordion-tab-title\" tabindex=\"0\" data-tab=\"1\" role=\"tab\" aria-controls=\"pp-accordion-tab-content-2511\" aria-expanded=\"false\">\n\t\t\t\t\t\t<span class=\"pp-accordion-title-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-accordion-title-text\">\n\t\t\t\t\t\t\t\tanatomy\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-accordion-toggle-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-close pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-down\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-open pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-up\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"pp-accordion-tab-content-2511\" class=\"pp-accordion-tab-content\" data-tab=\"1\" role=\"tabpanel\" aria-labelledby=\"pp-accordion-tab-title-2511\">\n\t\t\t\t\t\t<h4><span class=\"ez-toc-section\" id=\"thumb-2\"><\/span><span style=\"font-size: 14pt;\">thumb:<\/span><span class=\"ez-toc-section-end\"><\/span><\/h4><ul><li><span style=\"text-decoration: underline;\"><strong>tendons:<\/strong><\/span><ul><li><em>extensor pollicis longus(epl)<\/em> from compartment 3, inserts on the base of the distal phalanx.<\/li><li><em>extensor pollicis brevis (epb)<\/em> from the 1st wrist compatment to insert onto the base of the proximal phalanx.<\/li><li><em>abductor pollicis longus (apl)<\/em>\u00a0also from the 1st wrist compartment. inserts on the base of the 1st metacarpal.<\/li><\/ul><\/li><\/ul><figure id=\"attachment_14731\" aria-describedby=\"caption-attachment-14731\" style=\"width: 300px\" class=\"wp-caption alignnone\"><a href=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/thumb-extensors-anatomy.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-14731 size-medium\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/thumb-extensors-anatomy-300x236.jpg\" alt=\"anatomy of the thumb extensor tendons\" width=\"300\" height=\"236\" srcset=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/thumb-extensors-anatomy-300x236.jpg 300w, \/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/thumb-extensors-anatomy.jpg 656w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/a><figcaption id=\"caption-attachment-14731\" class=\"wp-caption-text\">anatomy of the thumb extensor tendons<\/figcaption><\/figure><h4><span class=\"ez-toc-section\" id=\"fingers-2\"><\/span><span style=\"font-size: 14pt;\">fingers:<\/span><span class=\"ez-toc-section-end\"><\/span><\/h4><ul><li><span style=\"text-decoration: underline;\"><strong>extensor\u00a0 tendons:<\/strong><\/span><ul><li><em>extensor digitorum (ed).<\/em>each of the 4 fingers has a single extensor digitorum tendon. from compartment 4 where it is the extensor communis and divides into 4 to insert on the base of each <span style=\"text-decoration: underline;\">middle<\/span> phalanx.<\/li><li><em>extensor indicis (ei)<\/em> is a 2nd extensor tendon to the index finger. it is also from compartment 4. at the level of the metacarpal head it joins with the ed tendon and also inserts on the base of the <span style=\"text-decoration: underline;\">middle phalanx<\/span> (slightly ulnar)<\/li><li><em>extensor\u00a0 digiti minimi (edm)<\/em> is a 2nd extensor tendon to the little finger. it is from compartment 5. at the level of the metacarpal head it joins with the ed tendon and also inserts on the base of the <span style=\"text-decoration: underline;\">middle phalanx<\/span> (slightly ulnar)<\/li><\/ul><\/li><li><span style=\"text-decoration: underline;\"><strong>extensor hood (eh):<\/strong><\/span><\/li><\/ul><ul style=\"list-style-type: circle;\"><li style=\"list-style-type: none;\"><ul style=\"list-style-type: circle;\"><li>the extensor hood overlies the extensor digitorum with fascial anchoring bands on each side.<\/li><li>at the level of the proximal interphalangeal joint it divides into 2 bands which rejoin for a common insertion on the base of the distal phalanx.<\/li><\/ul><\/li><\/ul><figure id=\"attachment_14732\" aria-describedby=\"caption-attachment-14732\" style=\"width: 295px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-14732\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-finger-extensor-tendon-anatomy-labelled-295x300.jpg\" alt=\"hand finger extensor tendon anatomy labelled\" width=\"295\" height=\"300\" srcset=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-finger-extensor-tendon-anatomy-labelled-295x300.jpg 295w, \/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/hand-finger-extensor-tendon-anatomy-labelled.jpg 657w\" sizes=\"(max-width: 295px) 100vw, 295px\" \/><figcaption id=\"caption-attachment-14732\" class=\"wp-caption-text\">anatomy of the hand &amp; finger extensor tendons.<\/figcaption><\/figure><h4><span class=\"ez-toc-section\" id=\"nailbed\"><\/span><span style=\"font-size: 14pt;\">nailbed:<\/span><span class=\"ez-toc-section-end\"><\/span><\/h4><ul><li>the nail, nail bed (matrix) and underlying bone surface can easily be assessed.<\/li><\/ul><figure id=\"attachment_14978\" aria-describedby=\"caption-attachment-14978\" style=\"width: 300px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-14978\" src=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/nail-anatomy-1-300x224.jpg\" alt=\"\" width=\"300\" height=\"224\" srcset=\"\/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/nail-anatomy-1-300x224.jpg 300w, \/\/www.iolishoes.com\/wp-content\/uploads\/2020\/12\/nail-anatomy-1.jpg 642w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-14978\" class=\"wp-caption-text\">anatomy of the nail apparatus<br \/>a, nail plate; b, proximal nail (eponychial) fold; c, hyponychium; d, nail bed (sterile matrix); e, nail bed (germinal matrix); f, periosteum; g, bone of distal phalanx.<br \/>reproduced with permission from melanoma institute australia, copyright roula drossis<\/figcaption><\/figure>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"pp-accordion-item\">\n\t\t\t\t\t\t\t\t\t\t<div id=\"pp-accordion-tab-title-2512\" class=\"pp-accordion-tab-title\" tabindex=\"0\" data-tab=\"2\" role=\"tab\" aria-controls=\"pp-accordion-tab-content-2512\" aria-expanded=\"false\">\n\t\t\t\t\t\t<span class=\"pp-accordion-title-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-accordion-title-text\">\n\t\t\t\t\t\t\t\tpatient position\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-accordion-toggle-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-close pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-down\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-open pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-up\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"pp-accordion-tab-content-2512\" class=\"pp-accordion-tab-content\" data-tab=\"2\" role=\"tabpanel\" aria-labelledby=\"pp-accordion-tab-title-2512\">\n\t\t\t\t\t\t<p><span style=\"color: #003366;\">to scan the hand and fingers:<\/span><\/p><ul><li>patient seated comfortably.<\/li><li>on the edge of the bed with their hand on a pillow on their lap, or seated on a chair on the opposite side of the bed with their arm outstretched towards you.<\/li><li>hand supported on a towel or similar.<\/li><\/ul><p>tip: you will need the ability to flex\/extend the fingers so ensure nothing obstructs this.<\/p>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"pp-accordion-item\">\n\t\t\t\t\t\t\t\t\t\t<div id=\"pp-accordion-tab-title-2513\" class=\"pp-accordion-tab-title\" tabindex=\"0\" data-tab=\"3\" role=\"tab\" aria-controls=\"pp-accordion-tab-content-2513\" aria-expanded=\"false\">\n\t\t\t\t\t\t<span class=\"pp-accordion-title-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-accordion-title-text\">\n\t\t\t\t\t\t\t\ttechnique\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-accordion-toggle-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-close pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-down\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-open pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-up\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"pp-accordion-tab-content-2513\" class=\"pp-accordion-tab-content\" data-tab=\"3\" role=\"tabpanel\" aria-labelledby=\"pp-accordion-tab-title-2513\">\n\t\t\t\t\t\t<p><span style=\"color: #003366;\">to examine the extensor apparatus of the finger:<\/span><\/p><ol><li>place the transducer transversely across the distal metacarpal just proximal to the knuckle. the extensor should be directly beneath the probe.<\/li><li>slide the probe distally in transverse following the extensor digitorum to the base of the middle phalanx.<\/li><li>rotate into longitudinal.<\/li><li>confirm the ed insertion.\u00a0<\/li><li>now move distally to confirm the extensor hood insertion to the distal phalanx.<\/li><li>to assess each band of the extensor hood, keep the distal end of the probe on the insertion and rotate the proximal end very slightly to the radial, then ulnar aspects.<\/li><li>dynamically assess the ed tendon sliding. at the level of the metacarpal head. importantly both in longitudinal and transverse (checking for tendon stability).<\/li><\/ol><p>tips:<\/p><ul><li>if you see a nice round ed tendon, it is probably abnormally thickened.<\/li><\/ul><p><span style=\"color: #003366;\">to examine the nail bed of the finger:<\/span><\/p><ol><li>place the transducer (++gel) longitudinally on the finger nail.<\/li><li>ensure you can see the nail root proximally.<\/li><li>slide sideways assessing the entire area.<\/li><li>rotate into transverse and assess proximaly-distally.<\/li><li>carefully check the underlying bony cortex for defects.<\/li><li>check with colour doppler.<\/li><\/ol><p>tips:<\/p><ul><li>if you are uncertain, check neighbouring fingers.<\/li><\/ul>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"pp-accordion-item\">\n\t\t\t\t\t\t\t\t\t\t<div id=\"pp-accordion-tab-title-2514\" class=\"pp-accordion-tab-title\" tabindex=\"0\" data-tab=\"4\" role=\"tab\" aria-controls=\"pp-accordion-tab-content-2514\" aria-expanded=\"false\">\n\t\t\t\t\t\t<span class=\"pp-accordion-title-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-accordion-title-text\">\n\t\t\t\t\t\t\t\tnormal appearances\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-accordion-toggle-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-close pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-down\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-open pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-up\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"pp-accordion-tab-content-2514\" class=\"pp-accordion-tab-content\" data-tab=\"4\" role=\"tabpanel\" aria-labelledby=\"pp-accordion-tab-title-2514\">\n\t\t\t\t\t\t<p><span style=\"color: #003366;\">normal appearance of the extensor tendons:<\/span><\/p><ol><li>transverse: echogenic and flat ovoid<\/li><li>longitudinal: echogenic and fibrillar.<\/li><li>size: &lt;2mm<\/li><li>no fluid should be visible.<\/li><li>dynamics: the extensor tendon should glide freely and with stability at the level of the mcpj with finger flexion\/extension.<\/li><\/ol><p><span style=\"color: #003366;\">normal appearance of the extensor hood:<\/span><\/p><ol><li>in the normal patient it cannot be seen independant of the extensor digitorum tendon.<\/li><li>each band over the middle phallanx should be thin, parallel echogenic lines, shlightly hypoechoic centrally (with current technology)<\/li><li>at the distal insertion it should be tapering, uniform, echogenic and fibrillar.<\/li><\/ol><p><span style=\"color: #003366;\">normal appearance of the nail bed:<\/span><\/p><ol><li>smooth underlying cortex<\/li><li>hypoechoic nail matrix<\/li><li>smooth, uniform parallel surfaces of the nail.<\/li><li>the nail should taper evenly to a sharp nail root.<\/li><li>uniform vascularity of the nail matrix with colour doppler.<\/li><\/ol>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<div class=\"pp-accordion-item\">\n\t\t\t\t\t\t\t\t\t\t<div id=\"pp-accordion-tab-title-2515\" class=\"pp-accordion-tab-title\" tabindex=\"0\" data-tab=\"5\" role=\"tab\" aria-controls=\"pp-accordion-tab-content-2515\" aria-expanded=\"false\">\n\t\t\t\t\t\t<span class=\"pp-accordion-title-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-accordion-title-text\">\n\t\t\t\t\t\t\t\twhat to look for?\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-accordion-toggle-icon\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-close pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-down\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class='pp-accordion-toggle-icon-open pp-icon'>\n\t\t\t\t\t\t\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-caret-square-up\"><\/i>\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\t\t<div id=\"pp-accordion-tab-content-2515\" class=\"pp-accordion-tab-content\" data-tab=\"5\" role=\"tabpanel\" aria-labelledby=\"pp-accordion-tab-title-2515\">\n\t\t\t\t\t\t<p><span style=\"color: #003366;\">once you identify the extensor apparatus of the finger:<\/span><\/p><ol><li>are they\u00a0 fibrillar and homogeneous?<\/li><li>do the gradually decrease in size distally?<\/li><li>there should be no fluid visible.<\/li><li>do they slide freely?<\/li><li>does the ed stay in place at the metacarpal head during finger flexion (transverse plane is best). if the ed subluxes, there is a likely tear of the sagittal band of the extensor hood.<\/li><li>are both bands of the distal extensor hood intact 9partial mallet finger)<\/li><\/ol><p><span style=\"color: #003366;\">once you identify the nail bed of the finger:<\/span><\/p><ol><li>is it uniform in thickness?<\/li><li>is there any underlying bony irregularity\/defect?<\/li><li>is there a mass\/collection?<\/li><li>is there focal hyperaemia on colour doppler?<\/li><\/ol>\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c36cded elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c36cded\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-e793fcb\" data-id=\"e793fcb\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-843c1f4 elementor-widget elementor-widget-heading\" data-id=\"843c1f4\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"extensor_digitorum\"><\/span>extensor digitorum<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2c39a8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2c39a8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-20a0e79b\" data-id=\"20a0e79b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-77116de4 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"77116de4\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4a6150d9 elementor-widget elementor-widget-text-editor\" data-id=\"4a6150d9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>scan plane extensor hood insertion to the base of the distal phalanx.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-3a4934\" data-id=\"3a4934\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-69389fe9 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"69389fe9\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<a class=\"elementor-flip-box__layer elementor-flip-box__back\" href=\"#elementor-action%3aaction%3dlightbox%26settings%3deyj1cmwioijodhrwolwvxc91bhryyxnvdw5kcgflzglhlmnvbvwvd3aty29udgvudfwvdxbsb2fkc1wvmjaymvwvmdhcl3vsdhjhc291bmqtzxh0zw5zb3itzglnaxrvcnvtlwluc2vydglvbi5qcgcilcj0exblijoiaw1hz2uilcj0axrszsi6ilvsdhjhc291bmqgb2ygdghligv4dgvuc29yigrpz2l0b3j1bsb0zw5kb24gaw5zzxj0aw9uig9udg8gdghligjhc2ugb2ygdghlig1pzgrszsbwagfsyw54lij9\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-8cea26 elementor-widget elementor-widget-text-editor\" data-id=\"8cea26\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound of the extensor digitorum tendon insertion onto the base of the middle phalanx.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5719fda3 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5719fda3\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-59cda851\" data-id=\"59cda851\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-612d415e elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"612d415e\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-5eb7437b elementor-widget elementor-widget-text-editor\" data-id=\"5eb7437b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>extensor digitorum tendon in the transverse plane, at the level of the metacarpal head.\u00a0<\/p><p>assess dynamically with fist clenching. the tendon should only move slightly. if it slides sideways (subluxes), there is a likely extensor hood sagittal band tear.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-4478d037\" data-id=\"4478d037\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-3aceaeb0 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"3aceaeb0\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<a class=\"elementor-flip-box__layer elementor-flip-box__back\" href=\"#elementor-action%3aaction%3dlightbox%26settings%3deyj1cmwioijodhrwolwvxc91bhryyxnvdw5kcgflzglhlmnvbvwvd3aty29udgvudfwvdxbsb2fkc1wvmjaymvwvmdhcl3vsdhjhc291bmqtzxh0zw5zb3itzglnaxrvcnvtlxrlbmrvbi10cmfuc3zlcnnllwhslmpwzyisinr5cguioijpbwfnzsisinrpdgxlijoivwx0cmfzb3vuzcbvzib0agugzxh0zw5zb3igzglnaxrvcnvtihrlbmrvbibpbibhicb0cmfuc3zlcnnlihbsyw5ligf0ihrozsbszxzlbcbvzib0agugtunqsi4ifq%3d%3d\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-47a31a50 elementor-widget elementor-widget-text-editor\" data-id=\"47a31a50\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>extensor digitorum tendon in the transverse plane, at the level of the metacarpal head.\u00a0<\/p><p>assess dynamically with fist clenching. the tendon should only move slightly. if it slides sideways (subluxes), there is a likely extensor hood sagittal band tear.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-71ff020a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"71ff020a\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-c4bc535\" data-id=\"c4bc535\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6796491f elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"6796491f\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2c4eb8f4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2c4eb8f4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-d97ea7d\" data-id=\"d97ea7d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7925bc9f elementor-widget elementor-widget-heading\" data-id=\"7925bc9f\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"extensor_hood\"><\/span>extensor hood<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f7177f0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f7177f0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-bc5a823\" data-id=\"bc5a823\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5e49d42 elementor-widget elementor-widget-text-editor\" data-id=\"5e49d42\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>extensor hood<\/strong><\/p><ul><li>the extensor hood overlies the extensor digitorum with fascial anchoring bands on each side.<\/li><li>at the level of the proximal interphalangeal joint it divides into 2 bands which rejoin for a common insertion on the base of the distal phalanx.<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-0170b56 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"0170b56\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-c741737\" data-id=\"c741737\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-831aa68 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"831aa68\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-85541b8 elementor-widget elementor-widget-text-editor\" data-id=\"85541b8\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>scan plane extensor hood insertion to the base of the distal phalanx.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-9768d12\" data-id=\"9768d12\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1812fc1 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"1812fc1\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<a class=\"elementor-flip-box__layer elementor-flip-box__back\" href=\"#elementor-action%3aaction%3dlightbox%26settings%3deyj1cmwioijodhrwolwvxc91bhryyxnvdw5kcgflzglhlmnvbvwvd3aty29udgvudfwvdxbsb2fkc1wvmjaymvwvmdhcl3vsdhjhc291bmqtzxh0zw5zb3itag9vzc1pbnnlcnrpb24uanbniiwidhlwzsi6imltywdliiwidgl0bguioijvbhryyxnvdw5kig9mihrozsblehrlbnnvcibob29kigluc2vydglvbibvbnrvihrozsbiyxnlig9mihrozsbkaxn0ywwgcghhbgfuec4ifq%3d%3d\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/a>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fd59c6e elementor-widget elementor-widget-text-editor\" data-id=\"fd59c6e\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound of the extensor hood insertion to the base of the distal phalanx.<\/p><p>note that the finger is slightly flexed to tighten the tendon.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5676ddad elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5676ddad\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-79529051\" data-id=\"79529051\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-786bbd8e elementor-grid-2 elementor-grid-tablet-2 elementor-grid-mobile-1 pp-video-gallery-content-below-video elementor-widget elementor-widget-pp-video-gallery\" data-id=\"786bbd8e\" data-element_type=\"widget\" data-settings=\"{&quot;layout&quot;:&quot;grid&quot;}\" data-widget_type=\"pp-video-gallery.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"pp-video-gallery-container pp-video-gallery-grid\">\n\t\t\t<div class=\"pp-video-gallery-wrap\">\n\t\t\t\t\t\t\t\t<div class=\"pp-video-gallery elementor-grid\" data-action=\"lightbox\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-grid-item-wrap elementor-grid-item filter-\">\n\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-container\">\n\t\t\t\t\t\t\t<div class=\"pp-video-play\" data-fancybox=\"video-gallery-786bbd8e\" href=\"https:\/\/vimeo.com\/586780354\">\n\t\t\t\t\t\t\t\t<div class=\"pp-media-overlay pp-video-overlay\"><\/div>\t\t\t\t\t\t\t\t<div class=\"pp-video-player\">\n\t\t\t\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"pp-video-thumb\" src=\"https:\/\/i.vimeocdn.com\/video\/1214009407-e0a548a3a3b5ee8a46e88c6ecdf28796ce37153a0cef73dc94a4100cc35cdf71-d_840\" alt=\"\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"pp-video-play-icon pp-icon\">\n\t\t\t\t<i aria-hidden=\"true\" class=\"far fa-play-circle\"><\/i>\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<div class=\"pp-video-content-container\">\n\t\t\t\t<div class=\"pp-video-content\">\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-title\">\n\t\t\t\t\t\t\textensor digitorum transverse ultrasound\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<div class=\"pp-video-description\">\n\t\t\t\t\t\t\tultrasound of the extensor digitorum tendon of the finger.\nfrom the level of the metacarpal head to the middle phalanx.\nthe tendon flattens as it approaches the insertion.\nthe extensor hood can be seen as hypoechoic oblique bands down from the sides of the tendon.\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f5a65c6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f5a65c6\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-a72c547\" data-id=\"a72c547\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9d360b9 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"9d360b9\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bc2ade0 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"bc2ade0\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-8d53ec4\" data-id=\"8d53ec4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-9d24535 elementor-widget elementor-widget-heading\" data-id=\"9d24535\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"nail_bed\"><\/span>nail bed<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-c9b8137 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"c9b8137\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-afa9521\" data-id=\"afa9521\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-046e8ac elementor-widget elementor-widget-text-editor\" data-id=\"046e8ac\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>nail bed<\/strong><\/p><p>assess uniformity of the underlying matrix and for a smooth, flat bone surface contour.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1662640f elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1662640f\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-1c18d422\" data-id=\"1c18d422\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7c88f031 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"7c88f031\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-04ce890 elementor-widget elementor-widget-text-editor\" data-id=\"04ce890\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>sac plane for the extensor digitorum insertion.<\/p><p>note the thick gel.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-7925ca1b\" data-id=\"7925ca1b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6b1880e6 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"6b1880e6\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0211fab elementor-widget elementor-widget-text-editor\" data-id=\"0211fab\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound of the nail bed is best viewed through a thick gel standoff.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5eff2711 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5eff2711\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7c15ffbe\" data-id=\"7c15ffbe\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6b091766 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"6b091766\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5c061f8 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5c061f8\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-aec663e\" data-id=\"aec663e\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-c84ad27 elementor-widget elementor-widget-heading\" data-id=\"c84ad27\" data-element_type=\"widget\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<h3 class=\"elementor-heading-title elementor-size-default\"><span class=\"ez-toc-section\" id=\"ulna_collateral_ligament_ucl_of_the_thumb_mcpj\"><\/span>ulna collateral ligament (ucl) of the thumb (mcpj)<span class=\"ez-toc-section-end\"><\/span><\/h3>\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5648218 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5648218\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b653945\" data-id=\"b653945\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-050453c elementor-widget elementor-widget-text-editor\" data-id=\"050453c\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p><strong>ulnar collateral ligament of the thumb (ucl)<\/strong><\/p><ul><li>the ulnar collateral ligament of the 1st metacarpo-phalangeal joint.<\/li><li>a forced abduction\/extension injury.<\/li><li>rupture is a skiier&#8217;s or gamekeeper&#8217;s thumb.<\/li><li>if the torn ligament folds under the adductor pollicis it is referred to as a &#8216;stenner lesion&#8217;.<\/li><\/ul><p><em><span style=\"text-decoration: underline;\">dynamically assess<\/span><\/em><\/p><ul><li>by gently flexing\/extending the tip of the thumb, whilst scanning the immobilised ucl of the mcpj (this takes some practice).<\/li><li>the adductor should be seen as a very thin hypoechoic band sliding superficially over the ucl. if it is sliding over the bone at the joint, there is a stenner lesion.<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2871ba57 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2871ba57\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-75fbc3ad\" data-id=\"75fbc3ad\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-6d278b8e elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"6d278b8e\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-0a0cfe0 elementor-widget elementor-widget-text-editor\" data-id=\"0a0cfe0\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>the ulnar collateral ligament on the 1st metacarpo-phalangeal joint.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<div class=\"elementor-column elementor-col-50 elementor-top-column elementor-element elementor-element-b128ced\" data-id=\"b128ced\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4e6280c6 elementor-flip-box--effect-fade elementor-widget elementor-widget-flip-box\" data-id=\"4e6280c6\" data-element_type=\"widget\" data-widget_type=\"flip-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-flip-box\" tabindex=\"0\">\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__front\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\t\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t<\/div>\n\t\t\t<div class=\"elementor-flip-box__layer elementor-flip-box__back\">\n\t\t\t<div class=\"elementor-flip-box__layer__overlay\">\n\t\t\t\t<div class=\"elementor-flip-box__layer__inner\">\n\t\t\t\t\t\n\t\t\t\t\t\n\t\t\t\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-617970d elementor-widget elementor-widget-text-editor\" data-id=\"617970d\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>ultrasound of the ucl of the 1st mcpj : rupture is called a skiier&#8217;s or gamekeeper&#8217;s thumb. if the torn ligament folds under the adductor pollicis it is referred to as a &#8216;stenner lesion&#8217;.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-27055f6 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"27055f6\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-2ae9063d\" data-id=\"2ae9063d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-5351a39 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"5351a39\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-439701cb elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"439701cb\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-578f3f47\" data-id=\"578f3f47\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-732fc2b0 elementor-widget elementor-widget-spacer\" data-id=\"732fc2b0\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-spacer\">\n\t\t\t<div class=\"elementor-spacer-inner\"><\/div>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-31e3dea9 elementor-widget elementor-widget-text-editor\" data-id=\"31e3dea9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h1 style=\"text-align: center;\">scan protocol<\/h1>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1d4531de elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1d4531de\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5d071fcc\" data-id=\"5d071fcc\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-44739bed elementor-widget elementor-widget-text-editor\" data-id=\"44739bed\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"role_of_ultrasound\"><\/span>role of ultrasound<span class=\"ez-toc-section-end\"><\/span><\/h3><p>to assess for:<\/p><ul><li>muscular, tendinous and ligamentous damage (chronic and acute).<\/li><li>foreign bodies.<\/li><li>joint effusions.<\/li><li>soft tissue masses such as ganglia, lipomas.<\/li><li>classification of a mass eg solid, cystic, mixed.<\/li><li>post surgical complications eg abscess, oedema.<\/li><li>guidance of injection, aspiration or biopsy.<\/li><li>relationship of normal anatomy and pathology to each other.<\/li><li>some bony pathology.<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-5ee9a6e5 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"5ee9a6e5\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-4f23257f\" data-id=\"4f23257f\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-253d4dd9 elementor-widget elementor-widget-text-editor\" data-id=\"253d4dd9\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"limitations\"><\/span>limitations<span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>open wounds<\/li><li>dressings<\/li><li>difficulty with probe contact due to curved \/flexed surfaces.<\/li><\/ul><div>\u00a0<\/div><p>\u00a0<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-40e778a4 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"40e778a4\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-b24049b\" data-id=\"b24049b\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-58dcb7a7 elementor-widget elementor-widget-text-editor\" data-id=\"58dcb7a7\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"patient_preparation\"><\/span>patient preparation<span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>nil<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-46853abf elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"46853abf\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-407de48d\" data-id=\"407de48d\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-58b0e82b elementor-widget elementor-widget-text-editor\" data-id=\"58b0e82b\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"equipment_setup\"><\/span>equipment setup<span class=\"ez-toc-section-end\"><\/span><\/h3><p>use of a high resolution probe (&gt;12mhz)with a small footprint is essential when assessing superficial structures. careful scanning technique to avoid anisotropy (and possible misdiagnosis). beam steering or compounding can help to overcome anisotropy in linear structures such as tendons. good colour \/ power \/ doppler capabilities when assessing vessels or vascularity of a structure. be prepared to change frequency output of probe (or probes) to adequately assess both superficial and deeper structures.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-1048a9d7 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"1048a9d7\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-419fe735\" data-id=\"419fe735\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-332842ac elementor-widget elementor-widget-text-editor\" data-id=\"332842ac\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"common_pathology\"><\/span>common pathology<span class=\"ez-toc-section-end\"><\/span><\/h3><ul><li>tendon tears<\/li><li>ligament tears<\/li><li>teno-synovitis<\/li><li>joint effusion<\/li><li>rheumatoid disease<\/li><li>foreign body<\/li><li>masses<\/li><li>fracture<\/li><li>ganglion<\/li><li>dupyetren&#8217;s<\/li><li>trigger finger<\/li><li>nail bed tumour<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-67d7e91e elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"67d7e91e\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7383c5de\" data-id=\"7383c5de\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2658055c elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"2658055c\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-685c5234 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"685c5234\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-55cfb7d4\" data-id=\"55cfb7d4\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-7343905 elementor-widget elementor-widget-text-editor\" data-id=\"7343905\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h1 style=\"text-align: center;\">scanning technique<\/h1>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-377f77b3 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"377f77b3\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-7b0d05ad\" data-id=\"7b0d05ad\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-1e4616a8 elementor-widget elementor-widget-text-editor\" data-id=\"1e4616a8\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<p>either:<\/p><ol><li>sit the patient on the side of the bed with a pillow on their lap to support their hand<\/li><li>sit the patient on a chair on the opposite side of the bed with their hand resting on the bed.<\/li><\/ol><p><strong>joint effusions<\/strong><\/p><p>for example images, click\u00a0<a href=\"\/\/www.iolishoes.com\/hand-finger-pathology\/\">here<\/a>\u00a0to goto the hand &amp; finger pathology page.<\/p><ul><li>size<\/li><li>simple\/complex<\/li><li>any synovial thickening<\/li><li>any vascularity on power doppler &#8211; normal is little or no discernable flow. hyperaemia = acute.<\/li><\/ul><p>may need to compare with the other side.<\/p><p><strong>tendon abnormalities<\/strong><\/p><p>for example images, click\u00a0<a href=\"\/\/www.iolishoes.com\/hand-finger-pathology\/\">here<\/a>\u00a0to go to the hand &amp; finger pathology page.<\/p><p>look for hyperaemia, tendon sheath fluid (simple\/complex) and tendon integrity\/homogeneity<\/p><ul><li>check for tendon thickening (compare with other side)<\/li><li>fluid in the tendon sheath<\/li><li>integrity of the tendon- any tear?<\/li><li>does the tendon slide freely when mobilised?<\/li><\/ul><p><strong>dupuytren&#8217;s contracture<\/strong><\/p><p>what is it?<\/p><ul><li>fibrosis of the palmer fascia forcing the flexion of the 4th\/5th fingers.<\/li><li>gradual onset<\/li><li>m&gt;f<\/li><li>often inherited.<\/li><li>generally affects 4th and 5th fingers.<\/li><\/ul><p>scan in longitudinal from the base of the proximal phalanx down into the palm looking superficial to the flexor tendon<\/p><p>it will appear as a hypoechoic focal fusiform thickening of the palmar fascia at the metacarpal head level. not to be confused with trigger finger (see below).<\/p><p><strong>trigger finger<\/strong><\/p><p>for example images, click\u00a0<a href=\"\/\/www.iolishoes.com\/hand-finger-pathology\/\">here<\/a>\u00a0to go to the hand &amp; finger pathology page.<\/p><p>what is it?<\/p><p>tenosynovitis of a flexor digitorum tendon causing forced flexion of a finger.<\/p><p>initially in transverse, identify the flexor digitorum tendons at the metacarpal head level. follow the common tendon proximally to the carpal tunnel. then follow distally to the insertions: the flexor digitorum superficialis divides, with two slips inserting onto the side of the base of the middle phalanx. flexor digitorum profundus inserts onto the distal phalanx<\/p><p><strong>finger pulleys<\/strong><\/p><p>for example images, click\u00a0<a href=\"\/\/www.iolishoes.com\/hand-finger-pathology\/\">here\u00a0<\/a>to go to the hand &amp; finger pathology page.<\/p><p>what are they? bands of fibrous tissue holding the flexor tendon to the finger similar to runners on a fishing rod.<\/p><p>they are named according to their type-annular (around) or cruciform (cross), and numbered from proximal to distal. eg: a1 to a5 and c1 to c4.<\/p><p>scan longitudinally over the anterior surface of the finger. the pulleys may be seen as thin hypoechoic zones intimately overlying the flexor tendon sheath.<\/p><p>if ruptured, the tendon will no longer follow the bone and will instead &#8220;bowstring&#8221;.<\/p><p><strong>game keepers thumb\/ skiiers thumb<\/strong><\/p><p>for example images, click\u00a0<a href=\"\/\/www.iolishoes.com\/hand-finger-pathology\/\">here<\/a>\u00a0to goto the hand &amp; finger pathology page.<\/p><p>what is it?<\/p><p>rupture of the ulnar collateral ligament of the thumb due to a sudden valgus force.<br \/>may occur after repeated stretching of the ligament.<\/p><p>the ligament usually tears at it&#8217;s distal end from the base of the proximal phalanx. if there is marked angulation of the phalanx, the flailing ligament may impinge under the adductor pollicis aponeurosis creating a &#8216; stenner lesion &#8216;.<\/p><p>click\u00a0<a href=\"http:\/\/www.wheelessonline.com\/ortho\/gamekeepers_thumb\" target=\"_blank\" rel=\"noopener\">here<\/a>\u00a0for detailed information.<\/p><p><strong>foreign bodies<\/strong><\/p><p>for example images, click\u00a0<a href=\"\/\/www.iolishoes.com\/pathology-handfinger\/\">here<\/a>\u00a0to goto the hand &amp; finger pathology page.<\/p><p>ensure you approach the proposed site of the foreign body from different angles. some materials will be poorly reflective and almost invisible unless the beam is perpendicular to them. there will usually be a surrounding hypoechoic halo representing an inflammatory reaction<\/p><p>identify:<\/p><ul><li>the plane of tissue it is in.<\/li><li>how close it is to the entry wound and to any blood vessels.<\/li><li>it may be helpful to mark the location and orientation of the foreign body on the skin to guide removal.<\/li><\/ul><p><strong>masses<\/strong><\/p><p>95% of finger tumours are benign(ref: emedicine)<\/p><ul><li>abscess<\/li><li>granuloma<\/li><li>ganglia<\/li><li>neuroma<\/li><li>fibroma<\/li><li>glomus tumour (nail bed tumour)<\/li><\/ul><p>for non-specific palpable or visible masses see our\u00a0<a href=\"\/\/www.iolishoes.com\/normal-superficial-lumps\/\">superficial lumps<\/a>\u00a0page.<\/p><p><strong>joint abnormalities<\/strong><\/p><p>for example images, click\u00a0<a href=\"\/\/www.iolishoes.com\/pathology-handfinger\/\">here<\/a>\u00a0to goto the hand &amp; finger pathology page.<\/p><ul><li>gout: abnormal uric acid metabolism resulting in joint inflammation. may see tophaceous gout as a complex echogenic mass (tophus) in the soft<\/li><li>osteoarthritis: bony irreg at the bone ends with joint effusion. when acute the joint will be hyperaemic<\/li><li>rheumatoid arthritis: thickened synovium with a complex &#8216;thick&#8217; joint effusion, pannus &amp; associated bony irregularity<\/li><\/ul><p>click\u00a0<a href=\"http:\/\/radiographics.rsna.org\/content\/25\/6\/1577.full?maxtoshow=&amp;hits=10&amp;hits=10&amp;resultformat=&amp;fulltext=ultrasound+finger&amp;andorexactfulltext=and&amp;searchid=1&amp;firstindex=0&amp;sortspec=relevance&amp;resourcetype=hwcit&amp;eaf%22%20target=%20blank\" target=\"_blank\" rel=\"noopener\">here<\/a>\u00a0to read a great article on hand ultrasound.<\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-69ae824c elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"69ae824c\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-1ee347f8\" data-id=\"1ee347f8\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-69f2c30 elementor-widget-divider--view-line elementor-widget elementor-widget-divider\" data-id=\"69f2c30\" data-element_type=\"widget\" data-widget_type=\"divider.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<div class=\"elementor-divider\">\n\t\t\t<span class=\"elementor-divider-separator\">\n\t\t\t\t\t\t<\/span>\n\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-68309e7a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"68309e7a\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-3ed00305\" data-id=\"3ed00305\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-66fa5feb elementor-widget elementor-widget-text-editor\" data-id=\"66fa5feb\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h3><span class=\"ez-toc-section\" id=\"basic_hardcopy_imaging\"><\/span>basic hardcopy imaging<span class=\"ez-toc-section-end\"><\/span><\/h3><p>hard copy imaging should reflect the anatomy investigated.<\/p><ul><li>document the normal anatomy. any pathology found in 2 planes, including measurements and any vascularity.<\/li><\/ul>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>click here for images of pathology, and detailed descriptions. palmar aspect the primary structures to examine are: flexor tendons and sheaths. joints pulleys volar plates neuro-vascular bundles flexor tendons anatomy thumb: pulleys: 2 annular pulleys and an oblique pulley (which arises from the aponeurosis of the adductor pollicis muscle (thenar eminence) tendons: flexor pollicis longus(fpl) [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"tags":[],"class_list":["post-305","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages\/305","targethints":{"allow":["get"]}}],"collection":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/comments?post=305"}],"version-history":[{"count":0,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/pages\/305\/revisions"}],"wp:attachment":[{"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/media?parent=305"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"\/\/www.iolishoes.com\/wp-json\/wp\/v2\/tags?post=305"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}