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The Accuracy of Ultrasonography in Detection of Ulnar Collateral Ligament of Thumb Injuries; a Cross-Sectional Study

Babak Shekarchi, Mohammadreza Mokhdanzadeh-Dashti, Mostafa Shahrezaei, Ebrahim Karimi




Introduction: Timely diagnosis and treatment of traumatic injury to ulnar collateral ligament (UCL) of thumb is of special importance for preserving the full function of the hand. Therefore, the present study has been designed with the aim of evaluating the accuracy of ultrasonography in detection of these injuries. Methods: The present diagnostic accuracy study was performed on traumapatients over 15 years oldwho had clinical evidence of injury to UCL of thumb and were admitted to the emergency department. All patients were evaluated regarding injury to the mentioned ligament via ultrasonography and MRI and finally, the accuracy of ultrasonography in this regard was measured considering MRI as the reference test. Results: 20 individuals with the mean age of 38.60 § 13.45 (16 – 64) years were evaluated (60% male). Based on ultrasonography andMRI findings 7 (35%) individuals and 7 (35%), respectively had complete ligament rupture (kappa: 0.560 (95% CI: 0.179 – 0.942)). Sensitivity, specificity, positive and negative predictive value, and positive and negative likelihood ratio of ultrasonography in detecting injuries of the mentioned ligament were 71.42 (30.25 – 94.88), 84.61 (53.66 – 97.28), 71.42 (30.25 – 94.88), 84.61 (53.66 – 97.28), 2.5 (0.71 – 8.82), and 0.18 (0.04 – 0.67), respectively. Conclusion: Based on the findings of the present study, performance of ultrasonography by a radiologist in the emergency department has 80% accuracy in detecting traumatic injuries of UCL of the thumb.


Ultrasonography; collateral ligament, ulnar; injuries; magnetic resonance imaging; dimensional measurement accuracy


Tang P. Collateral ligament injuries of the thumb metacarpophalangeal joint. Journal of the American Academy of Orthopaedic Surgeons. 2011;19(5):287-96.

Werner BC, Belkin NS, Kennelly S, Weiss L, Barnes RP, Rodeo SA, et al. Injuries to the Collateral Ligaments of the Metacarpophalangeal Joint of the Thumb, Including Simultaneous Combined Thumb Ulnar and Radial Collateral Ligament Injuries, in National Football League Athletes. The American journal of sports medicine. 2017;45(1):195-200.

Giele H,Martin J. The two-level ulnar collateral ligament injury of the metacarpophalangeal joint of the thumb. Journal of Hand Surgery. 2003;28(1):92-3.

BaskiesMA, Lee SK. Evaluation and treatment of injuries of the ulnar collateral ligament of the thumb metacarpophalangeal joint. Bulletin of the NYU hospital for joint diseases. 2009;67(1):68.

Keramidas E,Miller G. Adult hand injuries on artificial ski slopes. Annals of plastic surgery. 2005;55(4):357-8.

Patel S, Potty A, Taylor EJ, Sorene ED. Collateral ligament

injuries of the metacarpophalangeal joint of the thumb: a treatment algorithm. Strategies in Trauma and Limb Reconstruction. 2010;5(1):1-10.

Jones M, England S, Muwanga C, Hildreth T. The use of

ultrasound in the diagnosis of injuries of the ulnar collateral ligament of the thumb. Journal of Hand Surgery. 2000;25(1):29-32.

Mitsionis G, Varitimidis S, Sotereanos G. Treatment of

chronic injuries of the ulnar collateral ligament of the thumb using a free tendon graft and bone suture anchors. Journal of Hand Surgery. 2000;25(2):208-11.

Basar H, Basar B, Kaplan T, Erol B, Tetik C. Comparison of results after surgical repair of acute and chronic ulnar collateral ligament injury of the thumb. Chirurgie de la Main. 2014;33(6):384-9.

Avery DM, Caggiano NM,Matullo KS.Ulnar collateral ligament

injuries of the thumb: a comprehensive review.

Orthopedic Clinics. 2015;46(2):281-92.

Ritting AW, Baldwin PC, Rodner CM. Ulnar collateral ligament

injury of the thumb metacarpophalangeal joint. Clinical Journal of SportMedicine. 2010;20(2):106-12.

Schnur DP, DeLone FX, McClellan RM, Bonavita J, Witham RS. Ultrasound: a powerful tool in the diagnosis of ulnar collateral ligament injuries of the thumb. Annals of plastic surgery. 2002;49(1):19-23.

Arend CF, da Silva TR. The role of US in the evaluation of clinically suspected ulnar collateral ligament injuries of the thumb: spectrumof findings and differential diagnosis. Acta Radiologica. 2014;55(7):814-23.

HarperMT, Chandnani VP, Spaeth J, Santangelo JR, Providence BC, BaggMA. Gamekeeper thumb: diagnosis of ulnar

collateral ligament injury using magnetic resonance imaging, magnetic resonance arthrography and stress radiography. Journal of Magnetic Resonance Imaging. 1996;6(2):322-8.

Hergan K, Mittler C, Oser W. Ulnar collateral ligament: differentiation of displaced and nondisplaced tears with US andMR imaging. Radiology. 1995;194(1):65-71.

Papandrea RF, Fowler T. Injury at the thumb UCL: is there a Stener lesion? Journal of Hand Surgery. 2008;33(10):1882-4.

Hergan K, Mittler C. Sonography of the injured ulnar collateral ligament of the thumb. Bone & Joint Journal. 1995;77(1):77-83.

SusicD,Hansen BR,Hansen TB.Ultrasonography may be

misleading in the diagnosis of ruptured and dislocated ulnar collateral ligaments of the thumb. Scandinavian journal of plastic and reconstructive surgery and hand surgery. 1999;33(3):319-20.

Heyman P, Gelberman RH, Duncan K, Hipp JA. Injuries of the Ulnar Collateral Ligament of the Thumb Metacarpophalangeal Joint: Biomechanical and Prospective Clinical Studies on the Usefulness of Valgus Stress Testing. Clinical orthopaedics and related research. 1993;292:165-71.

Carr D, Johnson RJ, Pope MH. Upper extremity injuries in skiing. The American journal of sports medicine. 1981;9(6):378-83.

Plancher KD, Ho CP, Cofield SS, Viola R, Hawkins RJ. Role

of MR imaging in the management of" skier’s thumb" injuries. Magnetic resonance imaging clinics of North America. 1999;7(1):73-84.

Ahn JM, Sartoris DJ, Kang HS, Botte M, Trudell D,Haghighi P, et al. Gamekeeper thumb: comparison of MR arthrography with conventional arthrography and MR imaging in cadavers. Radiology. 1998;206(3):737-44.

Melville D, Jacobson JA, Haase S, Brandon C, Brigido MK,

Fessell D. Ultrasound of displaced ulnar collateral ligament tears of the thumb: the Stener lesion revisited. Skeletal radiology. 2013;42(5):667-73.

DOI: https://doi.org/10.22037/emergency.v6i1.20463


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