Ultrasonographic Diagnosis of Finger Flexor Tendon Hypoplasia in a Child with Phalangeal Agenesis

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

Thank you for the opportunity to review your manuscript, “Ultrasonographic Diagnosis of Finger Flexor Tendon Hypoplasia in a Child with Phalangeal Agenesis”

The article presents a case of flexor tendon agenesis. It is a simple article about a case, well-written with a coherent line of argument.

As a minor comment, the bibliography should be expanded somewhat, especially in the introduction part of the article. Specifically, about the use of ultrasonography, there is a lack of references to support the increasing use of high-frequency ultrasonography.

Author Response

Reviewer 1

Thank you for the opportunity to review your manuscript, “Ultrasonographic Diagnosis of Finger Flexor Tendon Hypoplasia in a Child with Phalangeal Agenesis”

The article presents a case of flexor tendon agenesis. It is a simple article about a case, well-written with a coherent line of argument.

As a minor comment, the bibliography should be expanded somewhat, especially in the introduction part of the article. Specifically, about the use of ultrasonography, there is a lack of references to support the increasing use of high-frequency ultrasonography.

Response:

We appreciate the thoughtful feedback provided by the reviewer. We concur with their assessment that this article, which focuses on a case, is well-written and presents a coherent line of argument. In response to the reviewer's suggestion, we have incorporated additional information to address the growing utilization of ultrasound in the evaluation of wrist and hand disorders. Specifically, we highlighted that "ultrasound has shown promise in assessing the triangular fibrocartilage complex and diagnosing nerve pathologies in the distal hand/wrist."

Furthermore, to support this statement, we have included references to two pertinent articles:

1. Ulnar Wrist Pain Revisited: Ultrasound Diagnosis and Guided Injection for Triangular Fibrocartilage Complex Injuries. J Clin Med 2019, 8, doi:10.3390/jcm8101540.
2. Ultrasound Imaging and Guidance for Distal Peripheral Nerve Pathologies at the Wrist/Hand. Diagnostics (Basel) 2023, 13, doi:10.3390/diagnostics13111928.

Reviewer 2 Report

Comments and Suggestions for Authors

Dear,

please find my comments attached.

 

Kind regards,

 

Comments for author File: Comments.pdf

Author Response

Reviewer 2

This article demonstrates evidence of direct clinical relevance by presenting a unique case of a 4-year-old girl with agenesis of the right third and fourth fingers, along with accompanying hypoplasia affecting multiple flexor tendons in the hand. The text highlights the rarity of this condition and the lack of previous studies addressing it, suggesting that it represents an uncommon and challenging clinical scenario. The use of ultrasound examination to reveal substantial thinning of the flexor tendons and hypoplasia of the middle phalanges adds further clinical detail and emphasizes the importance of thorough imaging in these situations. The recommendation for ultrasound, in conjunction with radiography, as the initial imaging tool demonstrates the practical relevance of this case report by providing guidance for clinicians encountering similar presentations in clinical practice. I welcome this article, which fits excellently into the Special Collection "Interesting Images," affirming ultrasound as a non-invasive diagnostic method in the pediatric patient population.

Response:

We express gratitude for the reviewer's generous comments. As recommended by the reviewer, our manuscript underscores the rarity of the presented condition, emphasizing the dearth of prior studies addressing agenesis of the right third and fourth fingers, coupled with concurrent hypoplasia affecting multiple flexor tendons in the hand. Additionally, our article demonstrates the utilization of ultrasound examination to unveil significant thinning of the flexor tendons and hypoplasia of the middle phalanges, providing valuable clinical details and highlighting the crucial role of comprehensive imaging in such cases. Once again, we value the reviewer's supportive remarks in endorsing the publication of our work.