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6b - Answer: 69-year-old male presents with left thumb dislocation one week prior

Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
Includes DICOM files

HISTORY: 

This 69-year-old male presents with left thumb dislocation one week prior. Evaluate ulnar collateral ligament of the thumb.

(QUIZ ANSWER) IS A FINDING IN THIS CASE: 

All of the above.

Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.

FINDINGS: 

Undisplaced fracture of the 1st metacarpal head and neck.

Contusion involving the ulnar sided palmar base of the proximal phalanx of the thumb.

Almost full thickness tear of the proximal attachment of the ulnar collateral ligament without Stener lesion.

Rupture of the proximal attachment of the radial collateral ligament with the displaced frayed end of the ligament lodged within the joint space.

Flexor pollicis longus tendon intact.

Background of 1st metacarpophalangeal joint degenerative change.

Small joint effusion.

Tear of the radial sided annular variable / oblique pulley of the thumb.

CONCLUSION:

1. Undisplaced, comminuted fracture of the 1st metacarpal head and neck. Microtrabecular fracture ulnar side proximal phalanx of the thumb.

2. UCL proximal attachment near full-thickness tear without Stener lesion.

3. Radial collateral ligament proximal tear with displaced frayed ligament lodged within the asymmetrically widened 1st MTP joint space.

4. Tear of the radial sided annular variable / oblique pulley of the thumb.

LESSON 2, TOPIC 18

Case Challenge: Thumb & Finger MRI Cases

Case Challenge

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Content reviewed: October 27, 2021

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