Value of high-resolution ultrasound in the evaluation of finger injuries in rock climbers

Aim: To determine the value of high-resolution ultrasound in the evaluation of finger injuries and changes due to strain in the fingers of extreme roc k climbers. Methods: Highfrequency ultrasound was performed on 208 fingers of 52 extreme rock climbers (mean age: 29.7 yrs) and on 80 fingers of 20 he althy volunteers (mean age: 28.5 yrs). The following parameters were sonogr aphically assessed: thickness of the pulley-system AZ, distance between pha lanx and tendon (PS distance), gliding ability of the flexor tendons, and t he periarticular and peritendinous space. The examination was performed on the handlying in a supinated position with extended fingers, followed by ac tive and passive flexion of about 40 degrees. All climbers also underwent c linical examination. Results: The pulley-system of climbers showed a signif icantly increased thickness of 0.17 (+/-0.09) cm compared with the healthy volunteers (p < 0.001). PS-distances of up to 0.51 (+/-0.15) cm were found only in symptomatic climbers and proved to be a sign of tendon bowstringing . No impairment of gliding ability was seen in both groups. Tendon sheath c ysts were detected in 76% (62) of symptomatic fingers of the climbers. Conc lusions: Non-invasive high-resolution ultrasound examination of fingers pro ved to be a very helpful method for diagnosing changes due to strain as wel l as finger injuries in rock climbers, especially in cases where the clinic al examination was difficult to perform.