Stephen Bird

Hi John,

You have given me some really nice images to review.

I am certain that your superficial head of FPB is normal from these images.

I can see a really nice facial boundary between opponens and the SHFPB and the muscle each side is beautiful and black.

The bright white thing on the other hand is not a tendon of SHFPB but rather just hitting the muscle edge (perimysium) at a skyline angle to make the white blob.

You are just skimming the muscle boundary.

So I am happy with all of the muscles, they are well preserved.

So if the FPL tendon with no inflammation of the radial bursa.


Your 1st CMC joint has some early arthritis changes and it is asymmetrical with the other side,

There are some sharp little osteophytes seen on the video which I think might play up during guitar sessions.

I am in favour of a diagnosis of a 1st CMC joint capsule injury at the time of trauma and some current overlying OA changes exacerbated by guitar leading to some synovitis and symptoms.

You may not see these changes easily on a plain radiograph.

I have attached some images and highlighted the areas I am talking about.

When you see the changes they may appear subtle but when you compare to the asymptomatic side you will be easily convinced.

Thanks so much for supporting the website, I really appreciate it,

Happy scanning,


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