0:01

As we think about the complication

0:02

of the ulnar collateral ligament lesion, in this case,

0:06

we can identify by having proximal migration

0:09

of the torn fibers of that UCL.

0:12

They come to lie superficial to the adductor a neurosis,

0:17

and really what happens here is that ligament can scar down

0:22

to the APO neurosis rather than

0:24

to its normal anatomic attachment.

0:27

Of course, this would result in an unstable articulation

0:31

and requires a surgical intervention.

0:34

So the definition of the standard lesion is

0:36

that the torn end of that UCL becomes displaced, superficial

0:41

to the adductor lysis, longus a neurosis

0:44

and interferes with normal healing

0:48

sequential T one coronal images.

0:50

Here again, when we're looking at the ulnar sided soft

0:53

tissues vary distorted heart to pick out

0:57

the ligament proper

0:59

as you look at the subc chondral bone plate.

1:02

In this case, maybe we're suspicious here

1:04

that there could be a small osseous fragment.

1:08

Then moving to the fluid sensitive sequence

1:11

or offered some background contrast that really helps us

1:14

to be able to characterize this lesion.

1:17

Again, looking at the ulnar base of the proximal phalanx,

1:21

that suspicion bore now probably a small piece of bone.

1:25

Here you can see the proximally retracted ligament with

1:28

that small bone fragment coming to lie superficial

1:31

to this linear low signal intensity structure.

1:35

That being the apo neurosis

1:36

of the adductor adductor lysis longus.

1:41

Another example here looking at the articular surface

1:45

proximal phalanx, you can clearly see that that's disrupted

1:49

as you move to the ulnar base here proximally, you can see

1:53

that fragment of bone

1:54

with the balled up ligament lying proximal

1:56

and superficial to this linear low signal intensity

2:00

structure that again, the a neurosis

2:02

of the aduc lysis longus this imaging finding that.

2:07

So-called yo-yo on a string, the yo-yo represented

2:11

by the ligament with or without the osseous fragment.

2:14

The string, the, a neurosis of the 80 Dr.

2:17

Lysis longus in this case.

2:19

Also able to identify the bone marrow edema, chondral loss,

2:24

and rather extensive edema surrounding the articulation.

2:30

Well here, two coronal images showing the fourth

2:34

and fifth metacarpal phal joint,

2:36

and this is a variation on that stenner lesion.

2:40

If you look at the radial aspect of the fifth MCP,

2:44

I think you can see a string here and perhaps I, yo-yo.

2:48

The anatomic theme here is that the torn

2:51

and retracted soft tissue structure has come

2:54

to lie superficial to this linear low signal intensity

2:58

Area. Again,

2:59

uh, that would prevent an anatomic, uh,

3:04

repair or anatomic healing process,

3:07

and so would require a surgical intervention in this case,

3:11

the pseudo stenner lesion represents the torn

3:14

radial collateral ligament of the fifth MP,

3:18

and it comes to lie superficial

3:20

to this linear low signal intensity structure here,

3:24

axial image through the fifth MCP.

3:26

Here's that ball up ligament superficial

3:29

to this linear low signal intensity structure,

3:32

which represents the sagittal band.

3:35

Don't be concerned if you're not exactly sure

3:38

what a Sagal band is.

3:39

We'll talk about that in much greater detail in just a few

3:42

moments.