Presentation
Twisting of both thumbs while playing volleyball one week ago. Both thumb MCP region ulnar side pain. Post-trauma immobilization was done. Ultrasound for ulnar collateral ligament evaluation.
Patient Data
The right thumb MCP joint shows avulsion of the ulnar collateral ligament from its distal attachment. There is no significant retraction. The ligament lies deep to the adductor aponeurosis. The radial collateral ligament of the MCP joint shows a normal echopattern. The collateral ligaments of the interphalangeal joints are also normal. MCP joint shows mild effusion in the dorsal recess. The flexor and extensor tendons of the thumb are intact.
The left thumb shows similar findings of the ulnar collateral ligament avulsion from its distal end. The avulsed ligament lies deep to the adductor aponeurosis. The radial collateral ligament of the MCP joint and collateral ligaments of interphalangeal joints are normal. MCP joint effusion is present in the dorsal recess. Tendons are normal.
Case Discussion
The patient had trauma to both thumbs while playing volleyball. Ultrasound shows avulsion of the ulnar collateral ligaments of both thumbs. There is no Stener lesion on either side.