Accuracy of Ultrasound Compared to Magnetic Resonance Imaging in the Diagnosis of Thumb Ulnar Collateral Ligament Injuries

Abstract

This prospective case series compared the accuracy of ultrasound (US) to magnetic resonance imaging (MRI) in differentiating complete displaced (CD) thumb ulnar collateral ligament (UCL) tears from nondisplaced injuries in 10 patients with suspected traumatic thumb UCL injuries. Ultrasound identified 100% (2 of 2) of MRI‐documented CD tears, both of which were further confirmed during surgical repair. Ultrasound identified the absence of CD tears in the remaining 8 patients. Although MRI is the reference standard imaging modality for characterizing thumb UCL injuries, ultrasound should be considered an accurate, cost‐effective, and alternative imaging modality to differentiate surgical versus nonsurgical thumb UCL injuries.

Routine use of ultrasound imaging to diagnose skier’s thumb. Results from a first-aid orthopedic department in an Italian ski resort

“…USS improves the detection rate of TMPJ lesions and is therefore particularly useful in high volume hospitals with large numbers of trauma patients. USS can lead to a significant decrease in the number of misdiagnoses as previously demonstrated by other studies 2,8,10,[16][17][18] . USS is likely to improve patient collaboration and could potentially supplant stress-test radiography which can be painful and potentially risky in some patients.…”

“…In the case of skiing accidents, the thumb is hyper-abducted at the MPJ by the ski pole which is fixed in the snow. Depending on the amount of external force applied, several different and progressively more severe clinical pictures and pathological presentations can occur 2,10 . Lesions can be classified as type I or sprain, type II or partial thickness tear, type III or full thickness tear, type IV or SL, and type V a combination of UCL lesion with fracture of the first phalanx of the ulnar base proximally dislocated.…”

Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injuries: Management and Biomechanical Evaluation

“…Although user-dependent, it has been shown to be highly sensitive and specific. A study by Moore et al 13 prospectively evaluated patients with clinically suspected UCL tears. Ultrasonography identified two of two complete UCL tears, confirmed by magnetic resonance imaging (MRI) and surgically, and eight of eight with no or partial tears when compared with MRI.…”

“…Ultrasonography identified two of two complete UCL tears, confirmed by magnetic resonance imaging (MRI) and surgically, and eight of eight with no or partial tears when compared with MRI. 13 Raheman et al 14 conducted a meta-analysis of ultrasonography diagnostic accuracy in UCL injuries. Seventeen studies were identified with a sensitivity and specificity of 96% and 90%, respectively, for diagnosing Stener lesions.…”

Acute Thumb Metacarpophalangeal Joint Ulnar Collateral Ligament Injury: Diagnosis, Management, and Return to Sports Considerations

“…Specificity for ruling in UCL tears was high as well at 90% (30,31). More recently, a prospective study evaluated 10 patients with acute thumb MCP joint injuries suspected of having UCL tears with both ultrasound and MRI (29). All (n = 2) patients with Stener lesion complete retracted tears were correctly identified on ultrasound.…”