Ultrasound versus MRI in the evaluation of the thumb metacarpophalangeal joint

Beatrice Knisely1, Shelley S. Noland2, David M. Melville3

Affiliation and address for correspondence
J Ultrason 2023; 23: e214–e222
DOI: 10.15557/JoU.2023.0030
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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.

ultrasound; thumb; metacarpophalangeal joint; MRI; collateral ligament
Video 1. 24-year-old female with volar plate injury. Dynamic US shows a focal hypoechoic cleft within the thickened and edematous volar plate during MCP joint flexion and extension, consistent with a tear
Video 2. Hand surgeon performs physical examination for assessment of proper and accessory ulnar collateral ligaments in normal volunteer
Video 3. 29-year-old female with partial UCL tear. Dynamic US imaging with slight valgus presence shows incomplete hypoechoic cleft, consistent with a partial tear
Video 4. 67-year-old female with trigger thumb. Dynamic US imaging shows severely restricted motion and kinking of the FPL and kinking during thumb flexion