Extensor Tendon Lacerations Workup

Updated: Jul 15, 2022
  • Author: Ginard I Henry, MD; Chief Editor: Joseph A Molnar, MD, PhD, FACS  more...
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Diagnostic Procedures

Bedside ultrasonography is more sensitive and specific than physical examination for detecting tendon lacerations. In one study, sensitivity, specificity, and accuracy of US were 100%, 95%, and 97%, respectively. A cadaveric study by Defzuli et al indicated that dynamic US has a sensitivity and specificity of 100% in detecting lacerations of the extensor tendons of the fingers and thumb, along with a positive predictive value of 1.0, and that static US has a sensitivity, specificity, and accuracy of 85%, 89%, and 88%, respectively. [19]

Bedside ultrasonography in the emergency department takes less time to perform than traditional wound exploration techniques or MRI. [8]

A 3-view x-ray of the hand, wrist, or forearm must be performed on all but the most benign extensor tendon laceration injuries to rule out foreign bodies or bony injury. Also, in all blunt trauma cases, radiographs are used to evaluate for possible fractures or dislocations.

For diagnosis of partial tears, which are especially common in rheumatoid patients, ultrasonography and MRI have been investigated but demonstrate a low sensitivity of 0.33 and 0.27, respectively. [20]