146
46TH
ANNUAL
CONGRESS
OF
THE
SAEVA
SKUKUZA
16-‐20
FEBRUARY
2014
with lack of a tear, but if signs are visible on scan it is likely there is a tear. Tears of
the manica flexoria are best imaged dynamically. The limb is held elevated, and is
flexed and extended while the tendon sheath is imaged in a longitudinal plane. In
cases with chronic tears the manica can be observed to bunch up in the proximal
tendon sheath.
Recently the use of positive contrast radiography has been “reinvented”. FiskeJackson (2011) described the technique. Positive contrast agent is injected into the
tendon sheath at the same time as intra-articular anaesthesia, followed by a lateral
radiograph. The manica flexoria is imaged as a thin fold of tissue outlined by
radiopaque contrast agent. The manica should be parallel to the deep digital flexor
tendon, and should extend down close to the proximal sesamoid bones. Thickening,
incongruity