Interosseous-lumbrical adhesions of the hand: contribution of magnetic resonance imaging to diagnosis and treatment planning.

Abstract

Previous investigators have not found magnetic resonance imaging (MRI) to be helpful in the diagnosis of interosseous-lumbrical tendon adhesions of the hand. We present 2 cases in which preoperative magnetic resonance images correlated with the clinical diagnosis and intraoperative finding of adhesions between the interosseous-lumbrical tendons at the level of the metacarpal head. Because there are no specific signs for the diagnosis, no palpable lesion, and no specific provocative test, the MRI acted to confirm the diagnosis in the presence of vague, nonspecific symptoms and provide objective evidence of the source of the patient's discomfort. This finding preserved surgery as a definite therapeutic rather than exploratory procedure, raising the confidence level of the operating surgeon as well as the patient. We believe that an MRI is beneficial in narrowing the differential diagnosis of interosseous-lumbrical adhesions, especially in difficult cases in which other underlying pathology may exist.