Ulnar Collateral Ligament Tears

Tears of the ulnar collateral ligament may occur following acute valgus stress injury to the elbow or following acute traumatic elbow dislocation [18,19].Ulnar collateral ligament tears are caused more commonly, however, by chronic repetitive stress to the elbow elicited by sports activities involving overhead throwing [20-23]. Most tears of the ulnar collateral ligament are full-thickness tears that involve the anterior bundle. The vast majority of these full-thickness tears occur in the midsubstance of the ligament. Complete soft tissue avulsions of the ulnar attachment and less commonly the humeral attachment of the anterior bundle can also occur [24,25]. Avulsion fractures of the sublime tubercle of the proximal ulna are rare but have been reported [26]. Partial-thickness tears of the ulnar collateral ligament also may occur. These partial-thickness tears, which involve the deep intracapsular layer of the anterior bundle, are especially common in baseball pitchers [27].

MRI of the elbow may be useful in evaluating the ulnar collateral ligament. The ulnar collateral ligament is visualized best on coronal Tl-weighted and proton density weighted MRI images. The anterior bundle appears as a thin band of low signal intensity that extends along the medial joint line of the elbow (Fig. 9). The posterior and transverse bundles are difficult to visualize as discrete structures on MRI images [28,29].

The MRI findings of a torn ulnar collateral ligament include redundancy, irregularity, and poor definition of the ligament and abnormal signal intensity within and adjacent to the ligament. The abnormal morphology and signal intensity of the torn ulnar collateral ligament is believed to be because of the presence of edema and hemorrhage within the injured ligament. MRI has a sensitivity of 100% and a specificity of 100% for detecting full-thickness tears of the anterior bundle of the ulnar collateral ligament (Fig. 10) [28,29]. MRI has

Rotator Cuff Mri Image

Fig. 9. Normal ulnar collateral ligament. Coronal fat-suppressed Tl-weighted spin-echo image of the elbow shows the normal low signal intensity anterior band of the ulnar collateral ligament (arrowhead) extending from the medial epicondyle to the medial aspect of the base of the coronoid process. Note that the distal insertion of the ulnar collateral ligament attaches within 1 mm of the articular margin of the coronoid process (arrow).

a sensitivity of only 57% for detecting partial-thickness ligament tears, however

MR arthrography of the elbow using saline or gadolinium intra-articular contrast also has been used to evaluate the ulnar collateral ligament. The presence of intra-articular contrast allows better delineation of the entire undersurface of the anterior bundle of the ulnar collateral ligament. On MR arthrography, intra-articular contrast can be seen filling the ulnar collateral recess of the elbow joint. This recess is a potential space beneath the medial epicondyle that is located between the undersurface of the proximal portion of the anterior bundle

Mri Showing Ucl Tear Elbow

Fig. 10. Full-thickness tear of the ulnar collateral ligament in a 21-year-old male baseball pitcher with medial elbow pain. Coronal fat-suppressed T2-weighted fast spin-echo image of the elbow shows complete disruption of the distal fibers of the anterior bundle of the ulnar collateral ligament (arrowhead) with surrounding periligamentous edema (arrow).

Fig. 10. Full-thickness tear of the ulnar collateral ligament in a 21-year-old male baseball pitcher with medial elbow pain. Coronal fat-suppressed T2-weighted fast spin-echo image of the elbow shows complete disruption of the distal fibers of the anterior bundle of the ulnar collateral ligament (arrowhead) with surrounding periligamentous edema (arrow).

Ucl Tear Mri

Fig. 11. Partial-thickness tear of the ulnar collateral ligament in a 19-year-old male baseball pitcher with medial elbow pain. Coronal fat-suppressed T2-weighted fast spin-echo image of the elbow shows thickening and irregularity of and intermediate signal intensity within the intact anterior bundle of the ulnar collateral ligament (arrowhead) with surrounding periligamentous edema (arrow).

Fig. 11. Partial-thickness tear of the ulnar collateral ligament in a 19-year-old male baseball pitcher with medial elbow pain. Coronal fat-suppressed T2-weighted fast spin-echo image of the elbow shows thickening and irregularity of and intermediate signal intensity within the intact anterior bundle of the ulnar collateral ligament (arrowhead) with surrounding periligamentous edema (arrow).

of the ulnar collateral ligament and the medial aspect of the trochlea. The distal insertion of the anterior bundle of the ulnar collateral ligament attaches within 1 mm of the articular margin of the coronoid process of the ulna (Fig. 9) [31]. Any intra-articular contrast extending below the attachment of the anterior bundle to the base of the coronoid process is abnormal and indicates a tear of the ulnar collateral ligament (Fig. 12). The presence of intra-articular contrast improves the sensitivity of MR imaging for detecting partial-thickness tears of the anterior bundle of the ulnar collateral ligament [32].

Fig. 12. Partial-thickness tear of the ulnar collateral ligament on MR arthrography in a 25-year-old male baseball pitcher with medial elbow pain. Coronal fat-suppressed T2-weighted spin-echo image of the elbow shows partial avulsion of the distal attachment of the anterior band of the ulnar collateral ligament from the medial aspect of the base of the coronoid process (arrowhead). Note that no contrast is seen extravasating into the periligamentous soft tissue indicating that only the deep fibers of the distal ulnar collateral ligament are torn.

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Responses

  • James
    When anterior band on elbow rips?
    6 years ago
  • niklas
    What is a partial thickness tear at the humeral attachment of medial collateral ligament?
    6 years ago
  • merry sandheaver
    IS THE ULNA COLLATERAL LIGAMENT INTRA ARTICULAR?
    6 years ago
  • vanessa
    What is an intensity line of the attachment of the ucl?
    6 years ago
  • mandy
    Why comman ulnar collateral ligament injury in picther how is it?
    6 years ago
  • daisy
    What is periligamentous soft tissue?
    5 years ago
  • LINNIE ROBINSON
    What doe thickening of ulnar collateral ligament mean on mri?
    5 years ago
  • Mustafa
    Can rest cure a tear in the ulnar collateral ligament?
    5 years ago
  • egidio
    What does an mri of an elbow with a UCL tear look like?
    5 years ago
  • Kristiina
    What does a small recess at the insertion of the UCL mean?
    4 years ago
  • Taimi
    WHAT DOES THICKENING WITH INCREASED T2 SIGNAL IN YOUR LATURAL ULNER COLLATERAL LIGAMENT MEAN?
    4 years ago
  • john
    What is the difference between partial thickness tear and full tearof ulnar collateral ligament?
    1 year ago
  • harri rinne
    Is mri 100% detecting ulnar collateral ligament tear?
    1 year ago

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