Revisiting the metacarpophalangeal joint: comparison of ultrasound tissue patterns with its anatomical, histological, and immunohistochemical features

Esperanza Naredo; Carlos Guillén-Astete; Otto Olivas-Vergara; Raquel Largo; José Ramón Mérida-Velasco; María del Carmen Barrio-Asensio; Cristina Vazquez-Carballo; Gabriel Herrero-Beaumont; Jacqueline Uson; Jorge Murillo-González

doi:10.1055/a-2595-9856

Ultraschall in der Medizin - European Journal of Ultrasound, Table of Contents

Ultraschall Med
DOI: 10.1055/a-2595-9856

Original Article

Revisiting the metacarpophalangeal joint: comparison of ultrasound tissue patterns with its anatomical, histological, and immunohistochemical features

Neubetrachtung des Metakarpophalangeal-Gelenks: Vergleich von Ultraschall-Gewebemustern mit anatomischen, histologischen und immunhistochemischen Merkmalen

Esperanza Naredo

¹Department of Rheumatology, Fundacion Jimenez Diaz University Hospital and Health Research Institute FJD-UAM, Madrid, Spain

²Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital and Health Research Institute FJD-UAM, Madrid, Spain

³Faculty of Medicine, Department of Medicine, Autonomous University of Madrid, Madrid, Spain

,

Carlos Guillén-Astete

⁴Department of Rheumatology, Ramon y Cajal University Hospital, Madrid, Spain

⁵Faculty of Biomedical and Health Sciences, Department of Medicine, European University of Madrid, Madrid, Spain

,

Otto Olivas-Vergara

¹Department of Rheumatology, Fundacion Jimenez Diaz University Hospital and Health Research Institute FJD-UAM, Madrid, Spain

²Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital and Health Research Institute FJD-UAM, Madrid, Spain

³Faculty of Medicine, Department of Medicine, Autonomous University of Madrid, Madrid, Spain

,

Raquel Largo

²Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital and Health Research Institute FJD-UAM, Madrid, Spain

³Faculty of Medicine, Department of Medicine, Autonomous University of Madrid, Madrid, Spain

,

José Ramón Mérida-Velasco

⁶Faculty of Medicine, Department of Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain

,

María del Carmen Barrio-Asensio

⁶Faculty of Medicine, Department of Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain

,

Cristina Vazquez-Carballo

²Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital and Health Research Institute FJD-UAM, Madrid, Spain

,

Gabriel Herrero-Beaumont

¹Department of Rheumatology, Fundacion Jimenez Diaz University Hospital and Health Research Institute FJD-UAM, Madrid, Spain

²Joint and Bone Research Unit, Fundacion Jimenez Diaz University Hospital and Health Research Institute FJD-UAM, Madrid, Spain

³Faculty of Medicine, Department of Medicine, Autonomous University of Madrid, Madrid, Spain

,

Jacqueline Uson

⁷Department of Rheumatology, Mostoles University Hospital, Móstoles, Spain (Ringgold ID: RIN16863)

⁸Faculty of Health Sciences, Department of Medicine, Rey Juan Carlos University of Madrid, Alcorcon, Spain

,

Jorge Murillo-González

⁶Faculty of Medicine, Department of Anatomy and Embryology, Complutense University of Madrid, Madrid, Spain

› Author Affiliations

Abstract

Purpose

This study aimed to identify the structures and tissues of the dorsal aspect of the metacarpophalangeal joint (MCPJ) using ultrasound, with gross anatomy as a comparator and learning source. In addition, the composition of several MCPJ tissues was investigated by histology and immunohistochemistry.

Materials and Methods

The study comprised 3 steps. First, 4 rheumatologist ultrasonographers identified on B-mode imaging the tissue patterns of the structures in the dorsal aspect of the MCPJ in fresh-frozen cadaveric hands. In the second step, 2 anatomists performed dissections on fresh-frozen and embalmed cadaveric hands to characterize the components of the dorsal MCPJ, providing anatomy-based feedback to aid ultrasound tissue interpretation. Histological and immunohistochemical analyses were also conducted on selected dorsal MCPJ tissues. In the third step, the anatomy and histology-based knowledge were applied to identify and evaluate these structures in healthy subjects using B-mode and Doppler mode ultrasound.

Results

Ultrasound examination of the cadaveric hands identified the key dorsal MCPJ structures, including the extensor tendon, joint capsule, dorsal plate, synovial recesses, and metacarpal head cartilage. Anatomical and histological analyses further characterized these structures, enhancing their identification in healthy subjects. Additionally, new insight into the histological and immunohistological features of these structures is provided.

Conclusion

Ultrasound successfully identified the main structures of the dorsal MCPJ. Integrating anatomical and histological features improved ultrasound imaging observations and confidence.

Zusammenfassung

Ziel

Ziel dieser Studie war die Identifizierung der Strukturen und des Gewebes des dorsalen Metakarpophalangeal-Gelenks (MCP) mittels Ultraschall. Die makroskopische Anatomie diente als Vergleichs- und Lernquelle. Zusätzlich wurde die Zusammensetzung verschiedener MCP-Gewebe histologisch und immunhistochemisch untersucht.

Material und Methoden

Die Studie umfasste 3 Schritte. Zunächst identifizierten 4 Rheumatologen im Ultraschall die Gewebemuster der Strukturen im dorsalen MCP-Bereich an frisch gefrorenen Leichenhänden mittels B-Bild-Bildgebung. Im zweiten Schritt führten 2 Anatomen Präparationen an frisch gefrorenen und einbalsamierten Leichenhänden durch, um die Komponenten des dorsalen MCPs zu charakterisieren und anatomisch fundierte Rückmeldungen zur Interpretation des Ultraschallgewebes zu liefern. Histologische und immunhistochemische Analysen wurden ebenfalls an ausgewählten dorsalen MCP-Geweben durchgeführt. Im dritten Schritt wurden die anatomischen und histologischen Erkenntnisse verwendet, um diese Strukturen bei gesunden Probanden mittels B-Mode- und Doppler-Ultraschall zu identifizieren und zu bewerten.

Ergebnisse

Die Ultraschall-Untersuchung der Leichenhände identifizierte die wichtigsten dorsalen MCP-Strukturen, darunter Strecksehne, Gelenkkapsel, palmare Platte, Recessus Synovialis und Metakarpalkopf-Knorpel. Anatomische und histologische Analysen charakterisierten diese Strukturen weiter und verbesserten ihre Identifizierung bei gesunden Probanden. Darüber hinaus wurden neue Erkenntnisse über die histologischen und immunhistologischen Merkmale dieser Strukturen gewonnen.

Schlussfolgerung

Mit Ultraschall konnten die Hauptstrukturen des dorsalen MCPs erfolgreich identifiziert werden. Die Integration anatomischer und histologischer Merkmale verbesserte die Ultraschall-Bildgebung und die Zuverlässigkeit der Ergebnisse.

Keywords

ultrasound - anatomy - metacarpophalangeal joint - histology - Musculoskeletal System

Full Text

References

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