To assess the efficacy of high frequency ultrasound in the diagnosis of Stener Lesion in terms of sensitivity,
postive predictive valve and negative predictive value.
Stener lesion is a unique variant of injury of the ulnar collateral ligament (UCL) of the thumb whereby the distal aspect of the UCL is avulsed from its insertion into the base of the proximal phalanx of the thumb.
The usually superficial abductor pollicis aponeurosis then becomes interposed between the avulsed UCL and the metacarpophalangeal (MCP) joint of the thumb.
This interposition prevents healing and necessitates surgical intervention to restore joint integrity and prevent long term...
Imaging findings OR Procedure Details
Over a 5 year period 228 patients were identified using a key word search of the radiology information system (RIS).
The surgical notes were then reviewed from all those pateint who proceded to surgery. All ultrasounds were conducted by MSK Consultant radiologist or Fellow. 191 were deemed to be negative for Stener lesion on US imaging,
of these 9 patients proceeded for surgical exploration on clinical grounds and all were found to be negative for Stener lesion. 28 were deemed to be positive...
the data suggests US has a high sensitivity for detection of stener lesion and is a powerful tool to exclude stener lesion.
Of the cases reviewed here all thosedeemed to be US negative were negative intraoperatively giving a sensitivity and negative predictive value of 100 % respectively. However in this review,
a positive US study only has a positive predictive value of 50% and a specificity of 53%. This would suggest that for a positive US study,
further assessment perhaps with...
Melville et al,
Ultrasound of displaced ulnar collateral ligament tears of the thumb: the Stener lesion revisited.
Skeletal Radiology2013 May; 42(5):667-73 Noszian et al,
Ulnar collateral ligament: differentiation of displaced and nondispalced tears with US.
1995 Jan;194(1):61-3 Hoglund et al,
Diagnosis by ultrasound of dislocated ulnar collateral ligament of the thumb.Acta Radiol.
1995 Nov;36(6):620-5. O'Callaghan et al,
Gamekeeper thumb: identification of the Stener lesion with...
Gareth Kiernan Clinical Fellow at the Musculoskeletal Radiology Department of theNuffield Orthopaedic Centre,
Oxford For questions and/or comments about this poster,
please contact me at: G.Kiernan@rbht.nhs.uk