Presentation
Fall on the ground resulting in the right thumb trauma about 10 days before the ultrasound. The initial radiograph was negative for a fracture/ dislocation. The patient was referred for an ultrasound evaluation of the ulnar collateral ligament.
Patient Data
There is a bony avulsion of MCP joint ulnar collateral ligament from the proximal phalanx base. The displacement is less than 1 mm. The ligament itself is intact with the presence of edema. There is no Stener lesion. The radial collateral ligament at the MCP joint is normal.
There is a minimally displaced fracture of the proximal phalanx distal shaft. The fracture line reaches near the ulnar collateral ligament of the interphalangeal joint which shows mild edema without any tear. The radial collateral ligament of the interphalangeal joint is normal.
There is no joint effusion.
Flexor and extensor tendons are normal. There is no flexor tenosynovitis.
Case Discussion
The case shows bony avulsion the ulnar collateral ligament (UCL) of the first metacarpophalangeal joint which is known as Gamekeeper's thumb. The additional findings are proximal phalanx shaft fracture and interphalangeal joint ulnar collateral ligament sprain.
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