Thickening of finger extensor tendons in affected hands among patients with stroke: prevalence and sonographic features.

OBJECTIVE: To evaluate the prevalence and sonographic characteristics of thickened finger extensor tendons in affected hands of patients with stroke.

DESIGN: Observational survey.

SUBJECTS: Thirty-six patients (12 women, 24 men) admitted for rehabilitation because of stroke.

CONTROL GROUP: 30 right-handed healthy volunteers.

METHODS: We used an 8-16 or a 6-12 MHz sonographic transducer to measure tendon thickness of the extensor digitorum communis of the middle (EDCiii) and ring (EDCiv) fingers at the wrist level.

RESULTS: The thickness of EDCiii (1.79 mm, standard deviation (SD) 0.56) and EDCiv (2.31 mm, SD 0.63) tendons of affected hands were significantly greater than those of the contralateral hands (EDCiii: 1.31 mm (SD 0.23), EDCiv: 1.59 mm (SD 0.46), p < 0.0001). When the upper limits of side-to-side tendon thickness differences were set at mean value plus 3 times SD among healthy volunteers (EDCiii: 0.60 mm, EDCiv: 0.74 mm), 18 (50%) patients and no volunteers had tendon thickening. No clinical features other than hand weakness correlated with tendon thickening.

CONCLUSION: Thickening of finger extensor tendons of the affected hands is common among stroke patients. It should be considered in the differential diagnosis of swelling of the dorsal wrists and hands in stroke-affected upper limbs.