Journal List > Korean J Sports Med > v.33(2) > 1054552

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Korean J Sports Med. 2015 Dec;33(2):75-82. Korean.
Published online December 07, 2015.  https://doi.org/10.5763/kjsm.2015.33.2.75
Copyright © 2015 The Korean Society of Sports Medicine
Gravity Valgus Stress Ultrasonographic Assessment of Ulnar Collateral Ligament Injury among Baseball Players
Tae Hyok Hwang, Hyung Lae Cho, Hyoung Min Kim, Ki Bong Park, and Hong Jo
Department of Orthopaedic Surgery, Good Samsun Hospital, Busan, Korea.

Correspondence: Ki Bong Park. Department of Orthopaedic Surgery, Good Samsun Hospital, 326, Gaya-daero, Sasang-gu, Busan 47007, Korea. Tel: +82-51-310-9289, Fax: +82-51-310-9348, Email: keybongpark@naver.com
Received July 09, 2015; Revised October 26, 2015; Accepted November 04, 2015.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

The purpose of this study is to evaluate the gravity valgus stress ultrasonographic findings of ulnar collateral ligament (UCL) injury among baseball players. 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. 22 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±1.5 mm and 2.5±0.43 mm, respectively; p=0.015). Significant increased average ulnohumeral distance in injured elbow was observed with complete UCL tears compared with partial tears (5.4±0.9 mm and 3.1±0.8 mm, 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±0.6 mm, respectively; p=0.012). 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.

Keywords: Elbow ultrasonography; Gravity valgus stress; Ulnar collateral ligament tear

Figures


 Fig. 1
(A) Photograph depicts technique for gravity valgus stress scanning of medial aspect of elbow. (B) Long axis sonographic view of uninjured medial elbow shows normal cord-like ulnar collateral ligament (asterisk) and measurement of ulnohumeral distance (d). U: ulna, H: humerus, ME: medial epicondyle.
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Fig. 2
Various abnormalities in gravity valgus stress sonographic scanning in ulnar collateral ligament tear players. Long axis views show (A) thickening and wavy contour of UCL (a) and increased joint effusion (b), (B) focal hypoechoic focus (c) corresponding to UCL tear, (C) small ossicles in UCL substance (d), (D) unfused apophyseal bone fragment (e) near UCL origin, (E) marginal osteophyte on medial trochlear edge (f) and (F) on ulnar sublime tubercle (g). U: ulna, H: humerus.
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Fig. 3
Bilateral gravity valgus stress sonographic images in (A) partial and (B) complete ulnar collateral ligament tear players show increased ulnohumeral distance (d1-d2) of 0.8 mm and 2.4 mm than uninjured left elbows, respectively. U: ulna, H: humerus.
Click for larger image

Tables


 Table 1
Demographic characteristics of patients
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Table 2
Abnormalities of injured elbow in gravity valgus stress ultrasonography
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Table 3
Ulnohumeral joint space in gravity valgus stress ultrasonography in all patients (total players n=28)
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Table 4
Ulnohumeral joint space in gravity valgus stress ultrasonography between two groups
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Notes

Conflict of Interest:No potential conflict of interest relevant to this article was reported.

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