Reason: Eval Thumb UCL History: instability Multiple sequences are limited by patient motion artifact and splint. Additionally, repeat images were not obtained due to the patient's inability to tolerate further imaging. The ulnar collateral ligament is abnormally thickened. There is increased signal intensity which traverses the proximal fibers of the ulnar collateral ligament that we suspect represents a complete tear, however, due to the thickening of the ligament, it is difficult to determine if this represents a mid substance tear or proximal avulsion with adjacent scar tissue. It is also difficult to determine whether this represents an acute or chronic tear or if there is a Stener lesion due to the thickening of the ligament and possible adjacent scar tissue. There is also intermediate signal intensity within the distal fibers of the ligament at its attachment which may correspond to the calcification seen on recent radiographs, perhaps representing further injury to the ligament. There is edema within the base of the proximal phalanx concentrated within the volar and ulnar aspect of the proximal phalanx, but we see no fracture. We see no edema within the sesamoid bones. There is mild edema along the myotendinous junction of the adductor pollicis suggesting a strain. Fibers of the radial collateral ligament can be traced from the first metacarpal head to the base of the proximal phalanx.
1. Limited study as described above due to patient motion artifact and inability of the patient to tolerate repeat images. The ulnar collateral ligament is thickened with what appears to be a full-thickness tear, but it is difficult to assess whether this is an acute or chronic lesion or if there is a Stener lesion.2. Strain of the adductor pollicis along the myotendinous junction and other findings as described above.