Right hand basilar and MCP joint pain. Evaluate for ligamentous disruption. A marker was placed on the skin along the thenar eminence. The musculature deep to this marker appears normal. Mild osteoarthritis affects the basilar joint, and there is slight dorsoradial subluxation of the first metacarpal relative to the trapezium. Portions of the anterior oblique ligament are poorly defined which may represent chronic degeneration and/or tearing. The dorsoradial ligament and what I believe to be the posterior oblique ligament appear intact. Increased signal intensity within the intermetacarpal ligament suggests mild degeneration. There is a small amount of fluid between the dorsoradial ligament and abductor pollicis longus tendon containing a small focus of low signal intensity corresponding to a small ossicle seen on recent radiographs. Additional small collections of fluid signal intensity are noted along the volar margin of the radioscaphoid articulation, perhaps representing ganglia arising from the long radiolunate and radioscaphocapitate ligaments. This study was not protocoled for detailed evaluation of the ligaments of the wrist, however.The proximal fibers of the ulnar collateral ligament of the first metacarpophalangeal joint are of intermediate signal intensity relative to the normal low signal intensity of the radial collateral ligament. This may reflect degeneration or probably perhaps a chronic partial-thickness tear. A small focus of fluid signal intensity superficial to the ligament may represent a small ganglion.The interphalangeal joint of the thumb appears normal. The flexor and extensor tendons of the thumb are unremarkable. Bone marrow signal intensity is within normal limits except for small tiny degenerative cysts in the base of the first metacarpal.
1.Osteoarthritis and subluxation of the first carpometacarpal joint, with poor definition of portions of the anterior oblique ligament that may represent chronic degeneration and/or tearing.2.Findings suggestive of degeneration or perhaps a chronic partial-thickness tear of the proximal fibers of the ulnar collateral ligament of the first metacarpophalangeal joint, with a small adjacent ganglion.3.Other findings as above.