Normal MRI of the Thumb

Normal MRI of the Thumb

Normal MRI of the Thumb


Introduction

This anatomical module of e-Anatomy is dedicated to the anatomy of the thumb with the normal MRI appearance of the phalanx bones, the MCP and IP joint with ligaments including volar plates, extensor and flexor mechanisms of the thumb, the thenar muscles and annular pulleys and synovial sheaths of the thumb on a high-resolution 3T MRI of the fingers (multiplanar T2-FS and T1 images).
This musculoskeletal anatomy atlas of the thumb has been designed to help radiologists in their daily practice. Thanks to the high-resolution 3-T MRI, the complex anatomy of the thumb can be imaged in exquisite detail to provide an accurate diagnosis of clinically important ligament and tendon injuries.

Material and methods

This MR of the thumb was carried out on a healthy male patient on a GE Signa Pioneer 3T MRI, by Corey Chakarun M.D. (Radiologist, Shin Imaging in California – USA).
We have focused the MR examination on the thumb but this MR imaging includes the index finger for comparison. We also used a large FOV as this protocol is used when tendon rupture or laceration is suspected (or when screening for inflammatory arthropathy), so that the retracted tendon can be localized , and also to display the carpometacarpal joint of the thumb.
The planes of the sections (sagittal, coronal and axial) were aligned to the digit of interest (thumb).
Imaging planes were chosen to best evaluate the anatomical structure injured:

  • The axial plane is important for evaluating all structures, particularly the volar plate and sagittal band.
  • The coronal plane is important for evaluating the collateral ligaments and articular cartilage.
  • The sagittal plane is important for evaluating the flexor and extensor tendons, volar plate, pulleys, and articular cartilage.

MRI sequences were chosen to optimize visualization of anatomy (T1-weighted, proton density–weighted) and fluid (fat-saturated [FS] T2-weighted, FS proton density–weighted, STIR).
The MRI parameters for thumb imaging used for this exam are provided below:

MRI sequence

Number of images

Slice thickness (mm)

TR (ms)

TE (ms)

FOV (mm)

Matrix

Resolution

Axial PD FS

30

3

1900

49

80

256x256

0.2x0.2x3

Axial T1

30

3

488

7

80

320x256

0.2x0.2x3

Sagittal PD FS

21

2

2645

28

80

352x256

0.2x0.2x3

Coronal T2 FSE FS

12

2

2035

92

80

320x256

0.2x0.2x3

Coronal T1

12

2

406

12

80

352x256

0.2x0.2x3

The images were then slightly cropped to focus on the thumb and second finger.
The anatomical structures were labeled by Antoine Micheau M.D. (Radiologist, Montpellier – France), using the Terminologia Anatomica 2.

 

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  • Rawat U, Pierce JL, Evans S, Chhabra AB, Nacey NC. High-Resolution MR Imaging and US Anatomy of the Thumb. Radiographics. 2016 Oct;36(6):1701-1716. doi: 10.1148/rg.2016160015. PMID: 27726751.
  • Cardoso FN, Kim HJ, Albertotti F, Botte MJ, Resnick D, Chung CB. Imaging the ligaments of the trapeziometacarpal joint: MRI compared with MR arthrography in cadaveric specimens. AJR Am J Roentgenol. 2009 Jan;192(1):W13-9. doi: 10.2214/AJR.07.4010. PMID: 19098167.
  • https://www.mainetsport.com/anat-trapezo-metacarpienne.html
  • Petchprapa CN, Vaswani D. MRI of the Fingers: An Update. AJR Am J Roentgenol. 2019 Sep;213(3):534-548. doi: 10.2214/AJR.19.21217. Epub 2019 Jul 3. PMID: 31268729.
  • Gupta P, Lenchik L, Wuertzer SD, Pacholke DA. High-resolution 3-T MRI of the fingers: review of anatomy and common tendon and ligament injuries. AJR Am J Roentgenol. 2015 Mar;204(3):W314-23. doi: 10.2214/AJR.14.12776. PMID: 25714317.
  • Clavero JA, Alomar X, Monill JM, Esplugas M, Golanó P, Mendoza M, Salvador A. MR imaging of ligament and tendon injuries of the fingers. Radiographics. 2002 Mar-Apr;22(2):237-56. doi: 10.1148/radiographics.22.2.g02mr11237. PMID: 11896215.
  • Terminologia anatomica: international anatomical terminology By the Federative Committee on Anatomical Terminology (FCAT).  Stuttgart:  Georg Thieme Verlag.  ISBN-10: 3-13-114361-4. ISBN-13: 978-3-13-114361-7
  • Pocket Atlas of Human Anatomy: 5th edition - W. Dauber, Founded by Heinz Feneis
  • Netter, Frank H. (2011) Atlas of human anatomy /Philadelphia, PA : Saunders/Elsevier
  • PROMETHEUS Anatomical Atlas for Students. General anatomy and musculoskeletal system Michael Schuenke, Erik Schulte, Udo Schumacher, Lawrence M. Ross Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System.Second Edition. 2014. Thieme Medical Publishers, Inc.: New York. ISBN: (Paperback) 978-1604069228. US