Reason: is there a UCL tear or other injury? History: swelling and pain, especially medially The anterior bundle of the ulnar collateral ligament, particularly its proximal fibers, are not visible, suggesting a full thickness tear. The proximal fibers of the lateral collateral ligament as well as the lateral ulnar collateral ligament are thickened and of increased signal intensity suggesting a sprain.Although the brachialis tendon and myotendinous junction appear intact, there is a large fluid-filled defect of the medial half of the distal brachialis muscle, indicating a high grade tear. Furthermore, there appears to be a complete tear of the pronator teres muscle 3-4 cm anterior to its origin from the medial epicondyle, with an intervening fluid collection that is continuous with the fluid-filled brachialis defect. There is edema within the torn proximal and distal fibers of the pronator teres. We suspect that there is also a full thickness tear through the adjacent flexor carpi radialis muscle. Furthermore, we see no discrete low signal intensity common flexor tendon arising from the medial epicondyle, suggesting a tear of this structure as well. There is mild edema within the palmaris longus and flexor digitorum superficialis muscles. The flexor digitorum profundus and flexor carpi ulnaris appear intact. The biceps muscle and tendon appear normal as do the triceps muscle and tendon. There is subcutaneous edema medially. There is edema along the myotendinous junction of the anconeus, suggesting a strain. There is mild increased signal intensity within the common extensor tendon, suggesting a strain injury with adjacent edema. The median nerve is visible coursing through the aforementioned fluid-filled intramuscular gaps, and appears intact. The ulnar nerve likewise appears intact. The radial nerve appears intact. There is edema within the radial head, concentrated laterally, with focal poor definition of the cortex that may represent a nondisplaced fracture, but this is equivocal. There is a joint effusion/hemarthrosis which appears to communicate anteriorly with the aforementioned intramuscular gap.
1.Full thickness tear of the anterior bundle of the ulnar collateral ligament. 2.High grade injuries to the flexor/pronator musculature and common flexor tendon as above3.Edema within the radial head suggesting a bone contusion and possibly an incomplete nondisplaced fracture. 4.Other findings as above. 