Ultrasound versus MRI in the evaluation of the thumb metacarpophalangeal joint

Knisely, Beatrice; Noland, Shelley S.; Melville, David M.

doi:10.15557/jou.2023.0030

Abstract

An intricate and unique combination of ligamentous, fibrocartilaginous, and osseous structures stabilize the thumb metacarpophalangeal joint. Both ultrasound and high-resolution magnetic resonance imaging are extremely useful in evaluating these critical structures. This article reviews common injuries of the thumb metacarpophalangeal joint, while highlighting the merits, limitations, and pitfalls of the two imaging modalities. A clear appreciation of each method, paired with anatomic knowledge, will lend greater confidence and accuracy to diagnosing impactful injuries and guiding intervention.

References

Martinoli C, Perez MM, Bignotti B, Airaldi S, Molfetta L, Klauser A et al.: Imaging finger joint instability with ultrasound. Semin Musculoskelet Radiol 2013; 17: 466–476. doi: 10.1055/s-0033-1360667.
Open DOI Search in Google Scholar Back to article
Rawat U, Pierce JL, Evans S, Chhabra AB, Nacey NC: High-resolution mr imaging and us anatomy of the thumb. Radiographics 2016; 36: 1701–1716. doi: 10.1148/rg.2016160015.
Open DOI Search in Google Scholar Back to article
Lee AT, Carlson MG: Thumb metacarpophalangeal joint collateral ligament injury management. Hand Clin 2012; 28: 361–370, ix–x. doi: 10.1016/j.hcl.2012.05.024.
Open DOI Search in Google Scholar Back to article
Daley D, Geary M, Gaston RG: Thumb metacarpophalangeal ulnar and radial collateral ligament injuries. Clin Sports Med 2020; 39: 443–455. doi: 10.1016/j.csm.2019.12.003.
Open DOI Search in Google Scholar Back to article
Posner MA, Retaillaud JL: Metacarpophalangeal joint injuries of the thumb. Hand Clin 1992; 8: 713–732.
Search in Google Scholar Back to article
Ebrahim FS, De Maeseneer M, Jager T, Marcelis S, Jamadar DA, Jacobson JA: US diagnosis of UCL tears of the thumb and Stener lesions: technique, pattern-based approach, and differential diagnosis. Radiographics 2006; 26: 1007–1020. doi: 10.1148/rg.264055117.
Open DOI Search in Google Scholar Back to article
Petchprapa CN, Vaswani D: MRI of the fingers: an update. Am J Roentgenol 2019; 213: 534–548. doi: 10.2214/AJR.19.21217.
Open DOI Search in Google Scholar Back to article
Manneck S, Del Grande F, Hirschmann A: Ulnar collateral ligament injuries of the first metacarpophalangeal joint: prevalence of associated injuries on radiographs and MRI. Skeletal Radiol 2021; 50: 505–513. doi: 10.1007/s00256-020-03575-w.
Open DOI Search in Google Scholar Back to article
Nakayama M, Sakuma Y, Tobimatsu H: Recurrent volar dislocation of the metacarpophalangeal joint of the thumb with radial collateral ligament injury: a case report. Int J Surg Case Rep 2020; 68: 96–99. doi: 10.1016/j.ijscr.2020.01.056.
Open DOI Search in Google Scholar Back to article
Cockenpot E, Lefebvre G, Demondion X, Chantelot C, Cotten A: Imaging of sports-related hand and wrist injuries: sports imaging series. Radiology 2016; 279: 674–692. doi: 10.1148/radiol.2016150995.
Open DOI Search in Google Scholar Back to article
Lee SA, Kim BH, Kim SJ, Kim JN, Park SY, Choi K: Current status of ultrasonography of the finger. Ultrasonography 2016; 35: 110–123. doi: 10.14366/usg.15051.
Open DOI Search in Google Scholar Back to article
Hirschmann A, Sutter R, Schweizer A, Pfirrmann CW: MRI of the thumb: anatomy and spectrum of findings in asymptomatic volunteers. Am J Roentgenol 2014; 202: 819–827. doi: 10.2214/AJR.13.11397.
Open DOI Search in Google Scholar Back to article
Ahn KS, Choi IC, Kang CH, Park JW: Ultrasound diagnosis and follow-up of a locked thumb metacarpophalangeal joint caused by radial sesamoid entrapment: a case report. BMC Musculoskelet Disord 2020; 21: 509. doi: 10.1186/s12891-020-03541-6.
Open DOI Search in Google Scholar Back to article
van der Naald M, van der Naald N, van der Velde D, Schuurman AH: Fracture of the sesamoid bone of the thumb: a case report and review of the literature. JBJS Case Connect 2019; 9:e10. doi: 10.2106/JBJS.CC.18.00147.
Open DOI Search in Google Scholar Back to article
Becciolini M, Bonacchi G: Fracture of the sesamoid bones of the thumb associated with volar plate injury: ultrasound diagnosis. J Ultrasound 2015; 18: 395–398. doi: 10.1007/s40477-015-0166-1.
Open DOI Search in Google Scholar Back to article
Bianchi S, Gitto S, Draghi F: Ultrasound features of trigger Finger: review of the literature. J Ultrasound Med 2019; 38: 3141–3154. doi: 10.1002/jum.15025.
Open DOI Search in Google Scholar Back to article
Patel MR, Pearlman HS, Bassini L, Ravich S: Fractures of the sesamoid bones of the thumb. J Hand Surg Am 1990; 15: 776–781. doi: 10.1016/0363-5023(90)90155-k.
Open DOI Search in Google Scholar Back to article
Bianchi S, Becciolini M: Ultrasound evaluation of sesamoid fractures of the hand: retrospective report of 13 patients. J Ultrasound Med 2019; 38: 1913–1920. doi: 10.1002/jum.14852.
Open DOI Search in Google Scholar Back to article
Avery DM 3rd, Inkellis ER, Carlson MG: Thumb collateral ligament injuries in the athlete. Curr Rev Musculoskelet Med 2017; 10: 28–37. doi: 10.1007/s12178-017-9381-z.
Open DOI Search in Google Scholar Back to article
Melville D, Jacobson JA, Haase S, Brandon C, Brigido MK, Fessell D: Ultrasound of displaced ulnar collateral ligament tears of the thumb: the Stener lesion revisited. Skeletal Radiol 2013; 42: 667–673. doi: 10.1007/s00256-012-1519-x.
Open DOI Search in Google Scholar Back to article
Qamhawi Z, Shah K, Kiernan G, Furniss D, Teh J, Azzopardi C: Diagnostic accuracy of ultrasound and magnetic resonance imaging in detecting Stener lesions of the thumb: systematic review and meta-analysis. J Hand Surg Eur Vol 2021; 46: 946–953. doi: 10.1177/1753193421993015.
Open DOI Search in Google Scholar Back to article
Bordet B, Borne J, Fantino O, Pialat JB: [US of the ulnal collateral ligament (UCL) at the first metacarpophalangeal (MCP) joint: a new dynamic maneuver to detect Stener lesions]. J Radiol 2009; 90: 217–220. In French. doi: 10.1016/s0221-0363(09)72472-2.
Open DOI Search in Google Scholar Back to article
Moore BJ, Iafrate JL, Kakar S, Wisniewski SJ, Murthy NS, Smith J: Accuracy of ultrasound compared to magnetic resonance imaging in the diagnosis of thumb ulnar collateral ligament injuries: a prospective case series. J Ultrasound Med 2021; 40: 1251–1257. doi: 10.1002/jum.15491.
Open DOI Search in Google Scholar Back to article
Shah CM, Sommerkamp TG: Fracture dislocation of the finger joints. J Hand Surg Am 2014; 39: 792–802. doi: 10.1016/j.jhsa.2013.10.001.
Open DOI Search in Google Scholar Back to article
Failla JM: Combined extensor pollicis brevis and radial collateral ligament injury: three case reports. J Hand Surg Am 1996; 21: 434–437. doi: 10.1016/S0363-5023(96)80359-5.
Open DOI Search in Google Scholar Back to article
Coyle MP Jr.: Grade III radial collateral ligament injuries of the thumb metacarpophalangeal joint: treatment by soft tissue advancement and bony reattachment. J Hand Surg Am 2003; 28: 14–20. doi: 10.1053/jhsu.2003.50008.
Open DOI Search in Google Scholar Back to article
Bhat AK, Mane PP, Acharya A, Madi S: Simultaneous combined complete tear of radial and ulnar collateral ligaments of thumb in an adolescent. BMJ Case Rep 2017; 2017. doi: 10.1136/bcr-2017-220550.
Open DOI Search in Google Scholar Back to article
Schubert MF, Shah VS, Craig CL, Zeller JL: Varied anatomy of the thumb pulley system: implications for successful trigger thumb release. J Hand Surg Am 2012; 37: 2278–2285. doi: 10.1016/j.jhsa.2012.08.005.
Open DOI Search in Google Scholar Back to article
Kosiyatrakul A, Jitprapaikulsarn S, Durand S, Oberlin C: Closed flexor pulley rupture of the thumb: case report and review of literature. Hand Surg 2009; 14: 139–142. doi: 10.1142/S0218810409004384.
Open DOI Search in Google Scholar Back to article
Giese J, Cerniglia C: Soft tissue injuries of the finger and thumb. Semin Ultrasound CT MR 2018; 39: 397–410. doi: 10.1053/j.sult.2018.04.001.
Open DOI Search in Google Scholar Back to article
Singh JP, Kumar S, Kathiria AV, Harjai R, Jawed A, Gupta V: Thumb ultrasound: technique and pathologies. Indian J Radiol Imaging 2016; 26: 386–396. doi: 10.4103/0971-3026.190408.
Open DOI Search in Google Scholar Back to article
Chang EY, Chen KC, Chung CB: MR imaging findings of trigger thumb. Skeletal Radiol 2015; 44: 1201–1207. doi: 10.1007/s00256-015-2172-y.
Open DOI Search in Google Scholar Back to article
Gruber H, Peer S, Loizides A: The “dark tendon sign” (DTS): a sonographic indicator for idiopathic trigger finger. Ultrasound Med Biol 2011; 37: 688–692. doi: 10.1016/j.ultrasmedbio.2011.01.019.
Open DOI Search in Google Scholar Back to article
Lapègue F, André A, Meyrignac O, Pasquier-Bernachot E, Dupré P, Brun C et al.: US-guided percutaneous release of the trigger finger by using a 21-gauge needle: a prospective study of 60 Cases. Radiology 2016; 280: 493–499. doi: 10.1148/radiol.2016151886.
Open DOI Search in Google Scholar Back to article

Ultrasound versus MRI in the evaluation of the thumb metacarpophalangeal joint

Abstract

Paradigm

My account