{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T08:03:23Z","timestamp":1779696203399,"version":"3.53.1"},"reference-count":23,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Accurate assessment of the A1 pulley is essential for the diagnosis and treatment of trigger finger, particularly in ultrasound-guided percutaneous release. Although high-resolution ultrasound is widely used to evaluate pulley morphology, the validity of sonographic measurements of A1 pulley length has not been clearly established against anatomical reference standard. This study evaluated the reliability and validity of ultrasound for measuring A1 pulley length and thickness in human cadavers and assessed the reproducibility of A2 pulley length. Twenty fingers from five fresh-frozen cadaveric hands were examined. Two blinded expert musculoskeletal sonographers independently performed ultrasound acquisition and measurements of A1 and A2 pulley length and A1 pulley thickness, while a third blinded observer obtained anatomical measurements after meticulous dissection using a digital caliper. Ultrasound systematically overestimated A1 pulley length compared with anatomical measurements and showed very poor reliability (ICC = 0.05) with wide limits of agreement. In contrast, A2 pulley length showed high interobserver reliability (ICC = 0.83) and relatively better agreement with anatomical values, whereas A1 pulley thickness showed moderate reproducibility (ICC = 0.61). Overall, A1 length measurements showed substantial variability and limited agreement, while A2 length and A1 thickness appeared more consistent within this experimental setting. These findings should be interpreted within the limitations of a cadaveric model.<\/jats:p>","DOI":"10.3390\/life16060867","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T06:42:18Z","timestamp":1779691338000},"page":"867","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reliability and Anatomical Agreement of High-Resolution Ultrasound for Measuring the Length and Thickness of the A1 Pulley: A Cadaveric Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Xeber","family":"Iruretagoiena","sequence":"first","affiliation":[{"name":"Deusto Physical TherapIker, Physical Therapy Department, Faculty of Health Sciences, University of Deusto, 20012 San Sebasti\u00e1n, Spain"},{"name":"Eskura Osasun Zentroa, 20200 Beasain, Spain"},{"name":"Sputnik Investigaci\u00f3n, 28232 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Blasi","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Hospital Germans Trias I Pujol, 08916 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram\u00f3n","family":"Balius","sequence":"additional","affiliation":[{"name":"Consell Catala de l\u2019Esport, Generalitat de Catalunya, 08950 Barcelona, Spain"},{"name":"Sport Medicine and Imaging Department, Cl\u00ednica Diagonal, 08950 Barcelona, Spain"},{"name":"Anatomy and Embryology Department, School of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Sala","sequence":"additional","affiliation":[{"name":"Anatomy and Embryology Department, School of Medicine, Universitat de Barcelona, 08007 Barcelona, Spain"},{"name":"Department of Anesthesiology, Hospital Cl\u00ednic de Barcelona, 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Garralda","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University Hospital of Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"De la Fuente","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Cl\u00ednica Pakea-Mutual\u00eda, 20018 San Sebasti\u00e1n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S1297-3203(02)00010-0","article-title":"Les poulies de l\u2019appareil fl\u00e9chisseur: Anatomie, pathologies, traitement","volume":"22","author":"Moutet","year":"2003","journal-title":"Chir. 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