Deep transverse metacarpal ligament = intermetacarpal ligament; interglenoid ligament
Definitions
Dislocation: complete dissociation of articular surfaces
Subluxation: partial dissociation of articular surfaces
Sprain: ligament injury
Types of collateral ligament injury
Gamekeeper's (skier's) thumb: sprain or tear of ulnar collateral ligament (UCL) of thumb (1st) MCP joint related to hyperabduction injury, ± avulsion fracture
Stener lesion: gamekeeper's thumb with retraction of torn UCL fibers & interposition of adductor pollicis aponeurosis between UCL & 1st metacarpal (MC)
Pseudoboutonnière deformity: extensor tendon central slip injury at or near insertion on middle phalanx, ± avulsion fracture of dorsal base of middle phalanx; results in PIP joint flexion with DIP joint extension
Pseudoboutonnière: results from PIP hyperextension with volar plate (VP) injury & intact extensor tendon; may cause PIP flexion contracture over time
Swan-neck deformity: PIP extension with DIP flexion; results from VP injury at PIP or extensor tendon injury at DIP
VP relation to collateral ligaments
Finger PIP & DIP
Proper collateral ligaments: insert on volar base of middle or distal phalanx, respectively
Accessory collateral ligaments: insert into VP, fan-shaped in PIP
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
Mechanisms of Injury
Joint Specific
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Petchprapa CN et al: MRI of the fingers: an update. AJR Am J Roentgenol. 213(3):534-48, 2019
Cockenpot E et al: Imaging of sports-related hand and wrist injuries: sports imaging series. Radiology. 279(3):674-92, 2016
Arend CF et al: The role of US in the evaluation of clinically suspected ulnar collateral ligament injuries of the thumb: spectrum of findings and differential diagnosis. Acta Radiol. 55(7):814-23, 2014
Hirschmann A et al: MRI of the thumb: anatomy and spectrum of findings in asymptomatic volunteers. AJR Am J Roentgenol. 202(4):819-27, 2014
Melville DM et al: Ultrasound of the thumb ulnar collateral ligament: technique and pathology. AJR Am J Roentgenol. 202(2):W168, 2014
Milner CS et al: Gamekeeper's thumb: a treatment-oriented MRI classification. J Hand Surg Am. 40(1):90-5, 2014
Martinoli C et al: Imaging finger joint instability with ultrasound. Semin Musculoskelet Radiol. 17(5):466-76, 2013
Melville D et al: Ultrasound of displaced ulnar collateral ligament tears of the thumb: the Stener lesion revisited. Skeletal Radiol. 42(5):667-73, 2013
Taylor KF et al: Radial collateral ligament injuries of the thumb metacarpophalangeal joint: epidemiology in a military population. J Hand Surg Am. 38(3):532-6, 2013
Scalcione LR et al: The athlete's hand: ligament and tendon injury. Semin Musculoskelet Radiol. 16(4):338-49, 2012
Tang P: Collateral ligament injuries of the thumb metacarpophalangeal joint. J Am Acad Orthop Surg. 19(5):287-96, 2011
Doty JF et al: Radial collateral ligament injury of the thumb with a Stener-like lesion. Orthopedics. 33(12):925, 2010
Ritting AW et al: Ulnar collateral ligament injury of the thumb metacarpophalangeal joint. Clin J Sport Med. 20(2):106-12, 2010
Carlsen BT et al: Thumb trauma: Bennett fractures, Rolando fractures, and ulnar collateral ligament injuries. J Hand Surg Am. 34(5):945-52, 2009
Ishizuki M et al: Stener-like lesions of collateral ligament ruptures of the metacarpophalangeal joint of the finger. J Orthop Sci. 14(2):150-4, 2009
Wessely K et al: Ultrasound findings of the locked metacarpophalangeal joint. Skeletal Radiol. 38(1):85-9, 2009
Ebrahim FS et al: US diagnosis of UCL tears of the thumb and Stener lesions: technique, pattern-based approach, and differential diagnosis. Radiographics. 26(4):1007-20, 2006
Kijowski R et al: The role of ultrasound in the evaluation of sports medicine injuries of the upper extremity. Clin Sports Med. 25(3):569-90, viii, 2006
Leggit JC et al: Acute finger injuries: part I. Tendons and ligaments. Am Fam Physician. 73(5):810-6, 2006
Rettig AC: Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med. 32(1):262-73, 2004
Rosner JL et al: Imaging of athletic wrist and hand injuries. Semin Musculoskelet Radiol. 8(1):57-79, 2004
Clavero JA et al: MR imaging of ligament and tendon injuries of the fingers. Radiographics. 22(2):237-56, 2002
Hinke DH et al: Ulnar collateral ligament of the thumb: MR findings in cadavers, volunteers, and patients with ligamentous injury (gamekeeper's thumb). AJR Am J Roentgenol. 163(6):1431-4, 1994
Eaton RG et al: Joint injuries and their sequelae. Clin Plast Surg. 3(1):85-98, 1976
Related Anatomy
Loading...
Related Differential Diagnoses
Loading...
References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Clinical Issues
Diagnostic Checklist
TERMINOLOGY
Synonyms
Deep transverse metacarpal ligament = intermetacarpal ligament; interglenoid ligament
Definitions
Dislocation: complete dissociation of articular surfaces
Subluxation: partial dissociation of articular surfaces
Sprain: ligament injury
Types of collateral ligament injury
Gamekeeper's (skier's) thumb: sprain or tear of ulnar collateral ligament (UCL) of thumb (1st) MCP joint related to hyperabduction injury, ± avulsion fracture
Stener lesion: gamekeeper's thumb with retraction of torn UCL fibers & interposition of adductor pollicis aponeurosis between UCL & 1st metacarpal (MC)
Pseudoboutonnière deformity: extensor tendon central slip injury at or near insertion on middle phalanx, ± avulsion fracture of dorsal base of middle phalanx; results in PIP joint flexion with DIP joint extension
Pseudoboutonnière: results from PIP hyperextension with volar plate (VP) injury & intact extensor tendon; may cause PIP flexion contracture over time
Swan-neck deformity: PIP extension with DIP flexion; results from VP injury at PIP or extensor tendon injury at DIP
VP relation to collateral ligaments
Finger PIP & DIP
Proper collateral ligaments: insert on volar base of middle or distal phalanx, respectively
Accessory collateral ligaments: insert into VP, fan-shaped in PIP
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
Staging, Grading, & Classification
Mechanisms of Injury
Joint Specific
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Petchprapa CN et al: MRI of the fingers: an update. AJR Am J Roentgenol. 213(3):534-48, 2019
Cockenpot E et al: Imaging of sports-related hand and wrist injuries: sports imaging series. Radiology. 279(3):674-92, 2016
Arend CF et al: The role of US in the evaluation of clinically suspected ulnar collateral ligament injuries of the thumb: spectrum of findings and differential diagnosis. Acta Radiol. 55(7):814-23, 2014
Hirschmann A et al: MRI of the thumb: anatomy and spectrum of findings in asymptomatic volunteers. AJR Am J Roentgenol. 202(4):819-27, 2014
Melville DM et al: Ultrasound of the thumb ulnar collateral ligament: technique and pathology. AJR Am J Roentgenol. 202(2):W168, 2014
Milner CS et al: Gamekeeper's thumb: a treatment-oriented MRI classification. J Hand Surg Am. 40(1):90-5, 2014
Martinoli C et al: Imaging finger joint instability with ultrasound. Semin Musculoskelet Radiol. 17(5):466-76, 2013
Melville D et al: Ultrasound of displaced ulnar collateral ligament tears of the thumb: the Stener lesion revisited. Skeletal Radiol. 42(5):667-73, 2013
Taylor KF et al: Radial collateral ligament injuries of the thumb metacarpophalangeal joint: epidemiology in a military population. J Hand Surg Am. 38(3):532-6, 2013
Scalcione LR et al: The athlete's hand: ligament and tendon injury. Semin Musculoskelet Radiol. 16(4):338-49, 2012
Tang P: Collateral ligament injuries of the thumb metacarpophalangeal joint. J Am Acad Orthop Surg. 19(5):287-96, 2011
Doty JF et al: Radial collateral ligament injury of the thumb with a Stener-like lesion. Orthopedics. 33(12):925, 2010
Ritting AW et al: Ulnar collateral ligament injury of the thumb metacarpophalangeal joint. Clin J Sport Med. 20(2):106-12, 2010
Carlsen BT et al: Thumb trauma: Bennett fractures, Rolando fractures, and ulnar collateral ligament injuries. J Hand Surg Am. 34(5):945-52, 2009
Ishizuki M et al: Stener-like lesions of collateral ligament ruptures of the metacarpophalangeal joint of the finger. J Orthop Sci. 14(2):150-4, 2009
Wessely K et al: Ultrasound findings of the locked metacarpophalangeal joint. Skeletal Radiol. 38(1):85-9, 2009
Ebrahim FS et al: US diagnosis of UCL tears of the thumb and Stener lesions: technique, pattern-based approach, and differential diagnosis. Radiographics. 26(4):1007-20, 2006
Kijowski R et al: The role of ultrasound in the evaluation of sports medicine injuries of the upper extremity. Clin Sports Med. 25(3):569-90, viii, 2006
Leggit JC et al: Acute finger injuries: part I. Tendons and ligaments. Am Fam Physician. 73(5):810-6, 2006
Rettig AC: Athletic injuries of the wrist and hand: part II: overuse injuries of the wrist and traumatic injuries to the hand. Am J Sports Med. 32(1):262-73, 2004
Rosner JL et al: Imaging of athletic wrist and hand injuries. Semin Musculoskelet Radiol. 8(1):57-79, 2004
Clavero JA et al: MR imaging of ligament and tendon injuries of the fingers. Radiographics. 22(2):237-56, 2002
Hinke DH et al: Ulnar collateral ligament of the thumb: MR findings in cadavers, volunteers, and patients with ligamentous injury (gamekeeper's thumb). AJR Am J Roentgenol. 163(6):1431-4, 1994
Eaton RG et al: Joint injuries and their sequelae. Clin Plast Surg. 3(1):85-98, 1976
STATdx includes over 200,000 searchable images, including x-ray, CT, MR, and ultrasound images. To access all images, please log in or subscribe.