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Ulnar Collateral Ligament Injury
Donna G. Blankenbaker, MD, FACRKirkland W. Davis, MD, FACRAndrew Sonin, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Ulnar collateral ligament (UCL)
              • Medial collateral ligament (MCL)
            • Synonyms

              • MCL injury
            • Definitions

              • Sprain, tear, or avulsion of UCL of elbow
              • UCL tear commonly refers to tear of anterior bundle

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            • Reporting Tips

                                              Selected References

                                              1. Cinque ME et al: Review of anatomy of the medial ulnar collateral ligament complex of the elbow. Curr Rev Musculoskelet Med. 13(1):96-102, 2020
                                              2. Park JY et al: Valgus stress ultrasound for medial ulnar collateral ligament injuries in athletes: is ultrasound alone enough for diagnosis? J Shoulder Elbow Surg. 29(3):578-86, 2020
                                              3. Chauvin NA et al: Magnetic resonance imaging of elbow injuries in children. Pediatr Radiol. 49(12):1629-42, 2019
                                              4. Lin DJ et al: Ulnar collateral ligament insertional injuries in pediatric overhead athletes: are MRI findings predictive of symptoms or need for surgery? AJR Am J Roentgenol. 212(4):867-73, 2019
                                              5. Wong TT et al: Elbow injuries in adult overhead athletes. AJR Am J Roentgenol. 208(3):W110-20, 2017
                                              6. Magee T: Accuracy of 3-T MR arthrography versus conventional 3-T MRI of elbow tendons and ligaments compared with surgery. AJR Am J Roentgenol. 204(1):W70-5, 2015
                                              7. Dugas J et al: Ulnar collateral ligament in the overhead athlete: a current review. Sports Med Arthrosc. 22(3):169-82, 2014
                                              8. Konin GP et al: US of the elbow: indications, technique, normal anatomy, and pathologic conditions. Radiographics. 33(4):E125-47, 2013
                                              9. Wenzke DR: MR imaging of the elbow in the injured athlete. Radiol Clin North Am. 51(2):195-213, 2013
                                              10. Meyers A et al: Ulnar collateral ligament reconstruction. Hand Clin. 24(1):53-67, 2008
                                              11. Schwartz ML et al: Avulsion of the medial epicondyle after ulnar collateral ligament reconstruction: imaging of a rare throwing injury. AJR Am J Roentgenol. 190(3):595-8, 2008
                                              12. Vitale MA et al: The outcome of elbow ulnar collateral ligament reconstruction in overhead athletes: a systematic review. Am J Sports Med. 36(6):1193-205, 2008
                                              13. Ouellette H et al: Imaging of the overhead throwing athlete. Semin Musculoskelet Radiol. 2005 Dec;9(4):316-33. Review. Erratum in: Semin Musculoskelet Radiol. 11(1):91, 2007
                                              14. Tran N et al: Ultrasonography of the elbow. Semin Musculoskelet Radiol. 11(2):105-16, 2007
                                              15. Safran M et al: Ulnar collateral ligament of the elbow. Arthroscopy. 21(11):1381-95, 2005
                                              16. Kaplan LJ et al: MR imaging of ligament injuries to the elbow. Magn Reson Imaging Clin N Am. 12(2):221-32, v-vi, 2004
                                              17. Munshi M et al: Anterior bundle of ulnar collateral ligament: evaluation of anatomic relationships by using MR imaging, MR arthrography, and gross anatomic and histologic analysis. Radiology. 231(3):797-803, 2004
                                              18. De Smet AA et al: Dynamic sonography with valgus stress to assess elbow ulnar collateral ligament injury in baseball pitchers. Skeletal Radiol. 31(11):671-6, 2002
                                              19. Salvo JP et al: Avulsion fracture of the ulnar sublime tubercle in overhead throwing athletes. Am J Sports Med. 30(3):426-31, 2002
                                              20. Glajchen N et al: Avulsion fracture of the sublime tubercle of the ulna: a newly recognized injury in the throwing athlete. AJR Am J Roentgenol. 170(3):627-8, 1998
                                              21. Nakanishi K et al: MR arthrography of elbow: evaluation of the ulnar collateral ligament of elbow. Skeletal Radiol. 25(7):629-34, 1996
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Ulnar collateral ligament (UCL)
                                                          • Medial collateral ligament (MCL)
                                                        • Synonyms

                                                          • MCL injury
                                                        • Definitions

                                                          • Sprain, tear, or avulsion of UCL of elbow
                                                          • UCL tear commonly refers to tear of anterior bundle

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            CLINICAL ISSUES

                                                                            • Presentation

                                                                              • Demographics

                                                                                • Natural History & Prognosis

                                                                                  • Treatment

                                                                                    DIAGNOSTIC CHECKLIST

                                                                                    • Consider

                                                                                      • Image Interpretation Pearls

                                                                                        • Reporting Tips

                                                                                          Selected References

                                                                                          1. Cinque ME et al: Review of anatomy of the medial ulnar collateral ligament complex of the elbow. Curr Rev Musculoskelet Med. 13(1):96-102, 2020
                                                                                          2. Park JY et al: Valgus stress ultrasound for medial ulnar collateral ligament injuries in athletes: is ultrasound alone enough for diagnosis? J Shoulder Elbow Surg. 29(3):578-86, 2020
                                                                                          3. Chauvin NA et al: Magnetic resonance imaging of elbow injuries in children. Pediatr Radiol. 49(12):1629-42, 2019
                                                                                          4. Lin DJ et al: Ulnar collateral ligament insertional injuries in pediatric overhead athletes: are MRI findings predictive of symptoms or need for surgery? AJR Am J Roentgenol. 212(4):867-73, 2019
                                                                                          5. Wong TT et al: Elbow injuries in adult overhead athletes. AJR Am J Roentgenol. 208(3):W110-20, 2017
                                                                                          6. Magee T: Accuracy of 3-T MR arthrography versus conventional 3-T MRI of elbow tendons and ligaments compared with surgery. AJR Am J Roentgenol. 204(1):W70-5, 2015
                                                                                          7. Dugas J et al: Ulnar collateral ligament in the overhead athlete: a current review. Sports Med Arthrosc. 22(3):169-82, 2014
                                                                                          8. Konin GP et al: US of the elbow: indications, technique, normal anatomy, and pathologic conditions. Radiographics. 33(4):E125-47, 2013
                                                                                          9. Wenzke DR: MR imaging of the elbow in the injured athlete. Radiol Clin North Am. 51(2):195-213, 2013
                                                                                          10. Meyers A et al: Ulnar collateral ligament reconstruction. Hand Clin. 24(1):53-67, 2008
                                                                                          11. Schwartz ML et al: Avulsion of the medial epicondyle after ulnar collateral ligament reconstruction: imaging of a rare throwing injury. AJR Am J Roentgenol. 190(3):595-8, 2008
                                                                                          12. Vitale MA et al: The outcome of elbow ulnar collateral ligament reconstruction in overhead athletes: a systematic review. Am J Sports Med. 36(6):1193-205, 2008
                                                                                          13. Ouellette H et al: Imaging of the overhead throwing athlete. Semin Musculoskelet Radiol. 2005 Dec;9(4):316-33. Review. Erratum in: Semin Musculoskelet Radiol. 11(1):91, 2007
                                                                                          14. Tran N et al: Ultrasonography of the elbow. Semin Musculoskelet Radiol. 11(2):105-16, 2007
                                                                                          15. Safran M et al: Ulnar collateral ligament of the elbow. Arthroscopy. 21(11):1381-95, 2005
                                                                                          16. Kaplan LJ et al: MR imaging of ligament injuries to the elbow. Magn Reson Imaging Clin N Am. 12(2):221-32, v-vi, 2004
                                                                                          17. Munshi M et al: Anterior bundle of ulnar collateral ligament: evaluation of anatomic relationships by using MR imaging, MR arthrography, and gross anatomic and histologic analysis. Radiology. 231(3):797-803, 2004
                                                                                          18. De Smet AA et al: Dynamic sonography with valgus stress to assess elbow ulnar collateral ligament injury in baseball pitchers. Skeletal Radiol. 31(11):671-6, 2002
                                                                                          19. Salvo JP et al: Avulsion fracture of the ulnar sublime tubercle in overhead throwing athletes. Am J Sports Med. 30(3):426-31, 2002
                                                                                          20. Glajchen N et al: Avulsion fracture of the sublime tubercle of the ulna: a newly recognized injury in the throwing athlete. AJR Am J Roentgenol. 170(3):627-8, 1998
                                                                                          21. Nakanishi K et al: MR arthrography of elbow: evaluation of the ulnar collateral ligament of elbow. Skeletal Radiol. 25(7):629-34, 1996