P71-T Distal digital phalanx pulp ultrasound images of individual fingers and toes

Abstract

Background Ultrasound can visualise digital pulp structures and provides precise measurements of the connective tissue compartments as well as recently described fluid filled sacculi which are accountable for distending digital pulp under normal circumstances and skin wrinkling after water immersion. Material and method A High Frequency (22 MHz) Ultrasound and Power Doppler imaging of the distal fingers and toes phalanx of a non-dominant hand and foot were carried out in a normal subject in both transverse and longitudinal planes. The US images were stored for offline quantitative and qualitative analysis. Results Based on the various digital pulp US echogenicity the following layers were depicted form ventral do dorsal direction in the fingers and toes: epidermis, dermis; vascularisation; hyper-echogenic areas (connective tissue compartments); hypo-echogenic areas (fluid filled sacculi) and distal phalanx bone. All fingers and toes showed similar distribution of the digital pulp structures whilst the number and area of the hyper-echogenic and hypo-ecogenic spaces varied for the individual fingers and toes. Conclusion The examples of individual fingers and toes distal phalanx ultrasound imaging provided can be used to determine and standardise the technique of digital pulp structures ultrasound assessment in normal physiological as well as in pathological conditions.