Thumb UCL Tear: MRI, Ultrasound, and Stener Lesion
Understand thumb UCL tear imaging, skier's thumb, Stener lesion suspicion, avulsion fragments, and when MRI or ultrasound is useful.
A thumb UCL tear injures the ligament that stabilizes pinch at the thumb MCP joint. Imaging is often used to look for an avulsion fracture, ligament discontinuity, and possible Stener lesion.
What MRI and Ultrasound Look For
- Partial versus complete UCL tear
- Displaced ligament stump suggesting Stener lesion
- Avulsion fragment at the ulnar base of the proximal phalanx
- MCP joint subluxation, edema, or associated volar plate injury
Key Takeaways
- X-ray checks for avulsion fracture and alignment
- MRI gives a broad view of ligament, marrow, and joint injuries
- Dynamic ultrasound can be excellent when local expertise is strong
Frequently Asked Questions
Does every thumb UCL tear need MRI?
No. Some are diagnosed from exam and X-ray. MRI or ultrasound is most useful when the tear grade, Stener lesion status, or associated injury is uncertain.
Why is pinch weakness important?
The thumb UCL stabilizes pinch. Ongoing instability can make keys, writing, tools, and sports grip difficult, so imaging findings should be matched to a hand exam.
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