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Thumb ultrasound: Technique and pathologies

View Article: PubMed Central - PubMed

ABSTRACT

Ultrasound is ideally suited for the assessment of complex anatomy and pathologies of the thumb. Focused and dynamic thumb ultrasound can provide a rapid real-time diagnosis and can be used for guided treatment in certain clinical situations. We present a simplified approach to scanning technique for thumb-related pathologies and illustrate a spectrum of common and uncommon pathologies encountered.

No MeSH data available.


Probe position and ultrasound images for evaluation of collateral ligaments metacarpophalengeal joint level (A-D). Probe position with hand in semipronation for UCL evaluation (A) with corresponding ultrasound image (B) shows the UCL (white arrow) and adductor aponeurosis (red arrow). Probe position with hand in semisupination for evaluation of the RCL (C) with corresponding ultrasound image (D) shows RCL (white arrow). (UCL - Ulnar collateral ligament, RCL - Radial collateral ligament)
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Figure 14: Probe position and ultrasound images for evaluation of collateral ligaments metacarpophalengeal joint level (A-D). Probe position with hand in semipronation for UCL evaluation (A) with corresponding ultrasound image (B) shows the UCL (white arrow) and adductor aponeurosis (red arrow). Probe position with hand in semisupination for evaluation of the RCL (C) with corresponding ultrasound image (D) shows RCL (white arrow). (UCL - Ulnar collateral ligament, RCL - Radial collateral ligament)

Mentions: To examine the Ulnar Collateral L igament (UCL), place the hand in a semipronated position [Figure 14A and B]. Coronal images are obtained by placing the probe at the long-axis of the thumb along the medial aspect of the first metacarpophalengeal joint. The examiner gives support and pressure from under the base of the thumb. Transverse images can be obtained by rotating the probe by 90°. Valgus stress views [Video 6] are taken in order to assess joint widening, compared with contralateral side. Stress testing is used to differentiate the torn ligament from an old scarred reattached ligament. The normal UCL [Figure 14B] is a hyperechoic structure spanning the ulnar side of the first metacarpophalangeal joint. Its configuration predisposes the deep fibers to anisotropy. Superficially, it is covered by an additional thin hyperechoic band corresponding to the adductor pollicis aponeurosis, which is variably visualized in the normal situation.[12] Gentle flexion of the metacarpophalan joints can be used to identify movement in the adductor aponeurosis. Similarly, the radial collateral ligament (RCL) can be evaluated [Figure 14C and D] by supinating the hand and placing the probe along the radial aspect of the first metacarpophalangeal joint.


Thumb ultrasound: Technique and pathologies
Probe position and ultrasound images for evaluation of collateral ligaments metacarpophalengeal joint level (A-D). Probe position with hand in semipronation for UCL evaluation (A) with corresponding ultrasound image (B) shows the UCL (white arrow) and adductor aponeurosis (red arrow). Probe position with hand in semisupination for evaluation of the RCL (C) with corresponding ultrasound image (D) shows RCL (white arrow). (UCL - Ulnar collateral ligament, RCL - Radial collateral ligament)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036340&req=5

Figure 14: Probe position and ultrasound images for evaluation of collateral ligaments metacarpophalengeal joint level (A-D). Probe position with hand in semipronation for UCL evaluation (A) with corresponding ultrasound image (B) shows the UCL (white arrow) and adductor aponeurosis (red arrow). Probe position with hand in semisupination for evaluation of the RCL (C) with corresponding ultrasound image (D) shows RCL (white arrow). (UCL - Ulnar collateral ligament, RCL - Radial collateral ligament)
Mentions: To examine the Ulnar Collateral L igament (UCL), place the hand in a semipronated position [Figure 14A and B]. Coronal images are obtained by placing the probe at the long-axis of the thumb along the medial aspect of the first metacarpophalengeal joint. The examiner gives support and pressure from under the base of the thumb. Transverse images can be obtained by rotating the probe by 90°. Valgus stress views [Video 6] are taken in order to assess joint widening, compared with contralateral side. Stress testing is used to differentiate the torn ligament from an old scarred reattached ligament. The normal UCL [Figure 14B] is a hyperechoic structure spanning the ulnar side of the first metacarpophalangeal joint. Its configuration predisposes the deep fibers to anisotropy. Superficially, it is covered by an additional thin hyperechoic band corresponding to the adductor pollicis aponeurosis, which is variably visualized in the normal situation.[12] Gentle flexion of the metacarpophalan joints can be used to identify movement in the adductor aponeurosis. Similarly, the radial collateral ligament (RCL) can be evaluated [Figure 14C and D] by supinating the hand and placing the probe along the radial aspect of the first metacarpophalangeal joint.

View Article: PubMed Central - PubMed

ABSTRACT

Ultrasound is ideally suited for the assessment of complex anatomy and pathologies of the thumb. Focused and dynamic thumb ultrasound can provide a rapid real-time diagnosis and can be used for guided treatment in certain clinical situations. We present a simplified approach to scanning technique for thumb-related pathologies and illustrate a spectrum of common and uncommon pathologies encountered.

No MeSH data available.