Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Case 19 Pseudodefect of the capitellum versus osteochondral defect
- Case 20 Pseudodefect of the trochlear groove versus fracture
- Case 21 Transverse trochlear ridge versus osteophyte or post-traumatic deformity
- Case 22 FABS positioning on MRI: demonstration of distal biceps tear
- Case 23 Ulnar collateral ligament tear versus normal recess of the elbow
- Case 24 T-sign of undersurface partial tear of the ulnar collateral ligament
- Case 25 Lateral ulnar collateral ligament tears
- Case 26 Locations and evaluation of loose bodies in the elbow joint
- Case 27 Osteochondritis dissecans of the elbow: stable versus unstable
- Case 28 Little Leaguer’s elbow: what is it?
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Index
- References
Case 24 - T-sign of undersurface partial tear of the ulnar collateral ligament
from Section 3 - Elbow
Published online by Cambridge University Press: 05 July 2013
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Case 19 Pseudodefect of the capitellum versus osteochondral defect
- Case 20 Pseudodefect of the trochlear groove versus fracture
- Case 21 Transverse trochlear ridge versus osteophyte or post-traumatic deformity
- Case 22 FABS positioning on MRI: demonstration of distal biceps tear
- Case 23 Ulnar collateral ligament tear versus normal recess of the elbow
- Case 24 T-sign of undersurface partial tear of the ulnar collateral ligament
- Case 25 Lateral ulnar collateral ligament tears
- Case 26 Locations and evaluation of loose bodies in the elbow joint
- Case 27 Osteochondritis dissecans of the elbow: stable versus unstable
- Case 28 Little Leaguer’s elbow: what is it?
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Index
- References
Summary
Imaging description
To reiterate, the anterior bundle of the ulnar collateral ligament (UCL) is best seen on coronally oriented MR arthrogram images. Based on prospective research, the insertion of the anterior bundle on the sublime tubercle should be tight with no visible recess between the coronoid process and the UCL in teenage and young adult baseball players. In young overhead-throwing athletes, an undersurface tear of the distal UCL is diagnosed if contrast is seen to extend between the sublime tubercle and the undersurface of the UCL. (Figure 24.1). This has been described as the T-sign. This finding or T-sign cannot be extrapolated as being abnormal in older adults as research has shown that this sign can be present in older adults in whom degenerative changes of the UCL may predominate.
Importance
Because of the difficulty in diagnosing partial tear of the anterior bundle of the UCL at physical examination and at arthroscopy, preoperative diagnosis with MR arthrography plays an important role in this injury. If this surgically treatable injury is missed, it causes an increase in patient morbidity and limitation in athletic performance due to a delay in the diagnosis.
Typical clinical scenario
The patient is usually a young adult male who is an overhead-throwing athlete (in the USA this is typically a baseball pitcher) and has slowly developed symptoms of medial elbow joint instability that are worse during the acceleration phase of the throwing motion.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Musculoskeletal ImagingVariants and Other Difficult Diagnoses, pp. 48 - 49Publisher: Cambridge University PressPrint publication year: 2013