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Sonographic diagnosis of an acute Stener lesion: a case report

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Abstract

This case report describes the use of diagnostic ultrasound to diagnose a Stener lesion in a patient who presented for conservative care of thumb pain following a fall on an outstretched hand. Conventional radiographic images demonstrated an avulsion fracture at the ulnar aspect of the base of the first proximal phalanx. Diagnostic ultrasound revealed a torn ulnar collateral ligament of the thumb that was displaced proximal to the adductor aponeurosis, consistent with a Stener lesion. Dynamic imaging with ultrasound confirmed displacement of the fully torn ligament. Surgical repair followed the diagnosis. Diagnostic ultrasound in this case provided an accurate diagnosis obviating further imaging. This allowed an optimal outcome due to early intervention.

Sommario

Il caso che presentiamo descrive l’uso dell’ecografia nella valutazione della lesione di Stener in un paziente che si è presentato con pollice dolorante, a seguito di caduta a mano tesa. Le immagini radiografiche convenzionali avevano mostrato una frattura da avulsione dell lato ulnare della base della falange prossimale. La diagnosi ecografica ha rivelato una rottura completa del legamento collaterale ulnare metacarpo-falangeo del pollice, ribaltato sull’ aponeurosi dell’adduttore (lesione di Stener). L’imaging dinamico con ecografia ha confermato il ribaltamento del legamento lacerato. In seguito alla diagnosi è stata eseguita riparazione chirurgica. In questo caso la valutazione ecografica si è rivelata utile per una diagnosi accurata, evitando ulteriori indagini ed ha permesso di ottenere un risultato ottimale con l’intervento immediato.

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Authors and Affiliations

  1. Department of Radiology, Logan University, 1851 Schoettler Road, Chesterfield, MO, 63017, USA

    Ross Mattox, Aaron B. Welk, Patrick J. Battaglia & Norman W. Kettner

  2. Clinical Intern, AUC School of Medicine, 1 University Drive at Jordan Road, Cupecoy, St. Maarten

    Frank Scali

  3. Chiropractic Health Center, Logan University, 1851 Schoettler Road, Chesterfield, MO, 63017, USA

    Mero Nunez

Authors
  1. Ross Mattox
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  2. Aaron B. Welk
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  3. Patrick J. Battaglia
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  4. Frank Scali
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  5. Mero Nunez
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  6. Norman W. Kettner
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Correspondence to Ross Mattox.

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The authors declare they have no conflicts of interest to disclose.

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The patient provided written informed consent for the inclusion of information that could potentially lead to her identification.

Human and animal studies

The case presented does not include any experimental procedures involving humans or animals.

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Online Resource 1 Normal thumb- US cine loop in the coronal plane along the ulnar aspect of the first MCP joint (J) during passive flexion of the first interphalangeal joint demonstrates gliding of the adductor aponeurosis (arrows) over intact fibers of the UCL (*) (WMV 1202 kb)

Online Resource 2 Injured thumb- US cine loop in the coronal plane along the ulnar aspect of the first MCP joint during passive flexion of the first interphalangeal joint demonstrates a heterogeneous soft tissue mass (*) representing the displaced UCL proximal to the free edge of the adductor aponeurosis (small arrows). The joint itself is gapping during this maneuver (large arrow) (WMV 2296 kb)

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Mattox, R., Welk, A.B., Battaglia, P.J. et al. Sonographic diagnosis of an acute Stener lesion: a case report. J Ultrasound 19, 149–152 (2016). https://doi.org/10.1007/s40477-015-0174-1

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  • DOI: https://doi.org/10.1007/s40477-015-0174-1

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