DOS 2017

DOS Kongressen 2017 ·

133

The value of magnetic resonance imaging (MRI) and ul-

trasound (UL) in diagnosing UCL ruptures of the thumb

Ellen Hamborg-Petersen, Trine Torfing, Bjarke Viberg

Department of Orthopaedic Surgery and Traumatology, Odense University

Hospital; Department of Radiology, Odense University Hospital; Department of

Clinical Research, University of Southern Denmark

Background:

Ulnar collateral ligament (UCL) tear of the first fingers MCP joint

is a common injury in the hand that often lead to surgery due to suspicion a

Stener lesion. If the UCL is undisplaced, surgery might not be necessary but a

reliable diagnostic imaging has not yet been evaluated.

Purpose / Aim of Study:

To evaluate if MRI or UL is sufficient to distinguish

between different types of UCL lesions in patients with clinical UCL ruptures of

the thumb.

Materials and Methods:

From 1/6 2014 to 31/5 2017 all patients with a

clinical UCL rupture diagnosed in the Emergency Department at Odense Uni-

versity Hospital was referred for a preoperatively MRI and UL of the injured

thumb. The MRI and UL was conducted by senior consultants with specialty in

musculoskeletal radiology. The result of the MRI and UL was blinded to the hand

surgeon who made an intraoperatively assessment of the UCL lesion which was

deemed as the Gold Standard (GS). A sample size estimated 30 patients using

99 % sensitivity, 0.05 accuracy and 50 % Stener prevalence. After 15 patients,

a new calculation was performed using the actual Stener prevalence yielding 46

patients.

Findings / Results:

50 patients were included. The mean age (standard devia-

tion) was 41.4 (16) and there were 64 % males. 5 patients did not have a UCL

lesion and the MRI had 80 % sensitivity (SN) and 100 % specificity (SP) while

the UL did not find any normal UCL compared to GS. The undisplaced UCL lesion

and no lesion was grouped and MRI had 67 % SN and 96 % SP while UL had 67

% SN and 61 % SP compared to GS. Grouping only Stener lesion, the MRI had 67

% SN and 82 % SP while UL had 42 % SN and 82 % SP compared to GS.

Conclusions:

Neither MRI or UL could with 100 % sensitivity diagnose undis-

placed or Stener UCL lesions of the thumb in patients with clinical UCL rupture.

No conflicts of interest reported

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