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

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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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Authors and Affiliations

  1. Department of Radiology, University of Michigan, 1500 East Medical Center Drive, 2910L, Ann Arbor, MI, 48109-0326, USA

    David Melville, Jon A. Jacobson, Catherine Brandon, Monica Kalume Brigido & David Fessell

  2. Department of Surgery, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI, 48109-0326, USA

    Steven Haase

Authors
  1. David Melville
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  2. Jon A. Jacobson
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  3. Steven Haase
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  4. Catherine Brandon
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  5. Monica Kalume Brigido
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  6. David Fessell
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Corresponding author

Correspondence to Jon A. Jacobson.

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Melville, D., Jacobson, J.A., Haase, S. et al. Ultrasound of displaced ulnar collateral ligament tears of the thumb: the Stener lesion revisited. Skeletal Radiol 42, 667–673 (2013). https://doi.org/10.1007/s00256-012-1519-x

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  • DOI: https://doi.org/10.1007/s00256-012-1519-x

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