High-Frequency and Contrast-Enhanced Ultrasound for Finger Tendon Injuries: Case Reports

Combining high-frequency ultrasound with contrast-enhanced ultrasound (CEUS) has proven effective in diagnosing and classifying finger extensor tendon injuries, providing critical information for preoperative evaluation. This case report presents three instances where this combined approach was utilized. In one case, a complete tendon rupture diagnosed via ultrasound matched surgical findings. In another, an incomplete rupture was confirmed clinically, while a distal phalangeal avulsion fracture initially missed on radiography was later identified through follow-up imaging. High-frequency ultrasound accurately determined tendon echogenicity, thickening, thinning, and other structural changes, while CEUS highlighted blood flow and contrast agent filling patterns, aiding in injury classification. By using both methods, clinicians could locate the severed tendon ends, assess the extent of injury, and develop personalized treatment plans. This combined imaging approach aligns with established CEUS applications for musculoskeletal conditions, although its use in finger extensor tendon injuries is novel. Previous studies have demonstrated the value of CEUS in other tendons, such as the rotator cuff and Achilles tendon. This technique enhances the accuracy of preoperative evaluations, ensuring optimal outcomes with minimal trauma. In clinical practice, the classification of tendon injuries—contusion, incomplete rupture, or complete rupture with or without avulsion—requires detailed imaging to guide treatment. By leveraging the capabilities of high-frequency ultrasound and CEUS, clinicians can improve diagnostic precision, reduce missed injuries, and enhance patient care. This combined approach represents a significant advancement in the imaging and management of tendon injuries, offering reliable preoperative insights that align with surgical findings.