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Skeletal Radiology
Published in: Skeletal Radiology 5/2013

01-05-2013 | Scientific Article

Ultrasound of displaced ulnar collateral ligament tears of the thumb: the Stener lesion revisited

Authors: David Melville, Jon A. Jacobson, Steven Haase, Catherine Brandon, Monica Kalume Brigido, David Fessell

Published in: Skeletal Radiology | Issue 5/2013

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Abstract

Purpose

To retrospectively characterize the ultrasound appearance of displaced ulnar collateral ligament (UCL) tears that are proven at surgery, and then determine the accuracy of the resulting ultrasound criteria in differentiating displaced from non-displaced UCL tears.

Materials and methods

After institutional review board approval, 26 patients were identified from the radiology information system over a 10-year period that had ultrasound evaluation of the thumb and surgically proven UCL tear. Retrospective review of the displaced full-thickness tears was carried out to characterize displaced tears and to establish ultrasound criteria for such tears. A repeat retrospective review 4 months later of all UCL tears applied the criteria to determine accuracy of ultrasound in the diagnosis of displaced full-thickness UCL tear.

Results

The 26 subjects consisted of 17 displaced full-thickness UCL tears, seven non-displaced full-thickness tears, and two partial-thickness tears at surgery. Retrospective ultrasound review of displaced full-thickness tears identified two criteria present in all cases: non-visualization of the UCL ligament and presence of a heterogeneous mass-like area proximal to the first metacarpophalangeal joint. Applying these criteria at the second retrospective review resulted in 100 % sensitivity, specificity, positive predictive value, negative predictive value, and accuracy.

Conclusions

The ultrasound findings of absent UCL fibers and presence of a heterogeneous mass-like abnormality proximal to the first metacarpophalangeal joint achieved 100 % accuracy in differentiating displaced from non-displaced full-thickness UCL tear of the thumb. Displaced full-thickness UCL tears most commonly were located proximal to the adductor aponeurosis.
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Metadata
Title
Ultrasound of displaced ulnar collateral ligament tears of the thumb: the Stener lesion revisited
Authors
David Melville
Jon A. Jacobson
Steven Haase
Catherine Brandon
Monica Kalume Brigido
David Fessell
Publication date
01-05-2013
Publisher
Springer-Verlag
Published in
Skeletal Radiology / Issue 5/2013
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-012-1519-x

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