2017 ISAKOS Biennial Congress ePoster #402

 

Gravity Valgus Stress Ultrasonographic Assessment of Ulnar Collateral Ligament Injury Among Baseball Players

Hyung-Lae Cho, MD, Busan KOREA, REPUBLIC OF
Hyoung Min Kim, MD, Busan KOREA, REPUBLIC OF
Ki-Bong Park, MD, Ulsan KOREA, REPUBLIC OF
Tae Hyun Wang, MD, Busan KOREA, REPUBLIC OF
Ji Un Kim, MD, Busan KOREA, REPUBLIC OF

Department of Orthopaedic Surgery, Good Samsun Hospital, Busan, KOREA, REPUBLIC OF

FDA Status Cleared

Summary

Gravity valgus stress sonographic assessment of ulnar collateral ligament injury

Abstract

Purpose

The purpose of this study is to evaluate the gravity valgus stress ultrasonographic findings of ulnar collateral ligament (UCL) injury among baseball players.
Materials & methods: Twenty-eight (Age 16-30, mean 19.5 years) UCL injured players, diagnosed by magnetic resonance imaging (MRI), were examined by bilateral elbow ultrasonography. On MRI findings, partial and complete tears were 17 and 11 players respectively. Ultrasonographic examinations were performed in 90 degree elbow flexion with gravity valgus stress, and abnormalities around UCL and ulnohumeral distance were compared with contralateral uninjured elbow.

Results

Twenty-two of 28 (79%) players had sonographic abnormalities in injured elbow such as thickening, wavy contour of the UCL (32%), hypoechoic foci in the ligament (43%), osteophyte on trochlear or ulnar articular margin (36%), joint effusion (29%) and ossicles in or around the UCL (68%) that were the most common finding in both partial and complete tears. In all players, the ulnohumeral distance was significantly wider on the injured side than it was on the uninjured side (4.0±1.5mm and 2.5±0.43mm, respectively; p=0.015). Significant increased average ulnohumeral distance in injured elbow was observed with complete UCL tears compared with partial tears (5.4±0.9mm and 3.1±0.8mm, respectively; p=0.021) and the mean difference between injured and uninjured elbow was more significant in complete tears than partial tears (2.8±1.2 mm and 0.7±0.6mm, respectively; p=0.012).

Conclusions

Gravity valgus stress ultrasonography is rapid noninvasive diagnostic tool and can provide clinicians valuable information regarding the condition of the UCL and medial elbow laxity in partial and complete UCL tear players.
Key words: elbow ultrasonography, gravity valgus stress, ulnar collateral ligament tear