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 23 - Ulnar collateral ligament tear versus normal recess of the elbow
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
Medical imaging assessment of the integrity of the ulnar collateral ligament (UCL) is best performed using MR arthrography of the elbow. The ulnar collateral ligament consists of three bundles: anterior, transverse, and posterior. Clinically significant tears of the UCL involve the anterior bundle since the anterior bundle is the primary restraint to valgus force on the elbow from 20° to 120° of flexion. This bundle is best seen on coronally oriented MR images. When normal, it is seen as a uniformly low-signal intensity band extending from the base of the medial epicondyle to the medial aspect of the coronoid process (known as the sublime tubercle) (Figure 23.1). A normal subligamentous recess is seen between the medial surface of the trochlea and the undersurface of the anterior bundle of the UCL on elbow MR arthrography; however, 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 young adults without ligamentous degeneration (Figure 23.2). A full thickness tear of the anterior bundle of the UCL is demonstrated by disruption of the fibers with abnormal insinuation of contrast into the tear (Figure 23.3). Full thickness tears most commonly occur in the midsubstance of the anterior bundle; however, avulsions at the epicondylar or tubercle attachments can occur.
Importance
Full thickness tears need to be identified by MR arthrography as the physical exam diagnosis of ruptures of the anterior bundle of the UCL can sometimes be difficult. If missed, this can cause an increase in patient morbidity due to a delay in diagnosis and definitive surgical treatment.
- Type
- Chapter
- Information
- Pearls and Pitfalls in Musculoskeletal ImagingVariants and Other Difficult Diagnoses, pp. 45 - 47Publisher: Cambridge University PressPrint publication year: 2013