PMC5439395_01
Ultrasound study of the right hand and wrist. (a) Linear calcifications of the middle finger tendon sheath of flexor digitorum superficialis and flexor digitorum profundus (arrow). Flexor tendons appear to be distorted (red line) when pass through the distal edge of transverse carpal ligament (star mark). (b) Linear calcifications of the ring finger tendon sheath of flexor digitorum superficialis and flexor digitorum profundus (arrow). Flexor tendons appear to be distorted (red line) when pass through the distal edge of transverse carpal ligament (star mark). (c) Flexor tendons of middle finger (MF) and ring finger (RF) are round and smooth at A1 pulley level (transection view).
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At about the level of the mid-palm, there were linear calcifications related to the middle and ring finger tendon sheath (Figure 1(a),(b)). Tendons were round and smooth at A1 pulley level (Figure 1(c)).
Plain X-ray of right wrist: anterior-posterior view and lateral view. No evident calcification seen along the passage of flexor tendons.
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These calcifications were not evident on plain X-ray (Figure 2), which was normal with no significant degenerative changes seen in carpal joints.
Carpal tunnel after surgical release. No extra lumbricals or mass was seen. (a) With all fingers fully extended. (b) With all fingers fully flexed.
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No extra lumbricals or mass lesions were seen on visible tendons throughout their excursions within the carpal tunnel (Figure 3(a),(b)).
Calcific plaques of the tendon sheath (black arrow).
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Tendons were otherwise healthy. (Figure 4).