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Sanglim Lee, M.D., Ph.D., Eui Yub Jung, M.D., Jihae Lee, M.D.*, Suk Ha Jeon, M.D.†
Abstract
Three Stener-like lesions of the metacarpophalangeal joint of the fingers and a rupture of the first dorsal interosseous muscle mimicking the lesion in the index finger were observed. Two cases in the little fingers had a true Stener's lesion. In one case in the index finger, the ruptured ligament was retracted and located under the intact sagittal band, which was also observed by preoperative magnetic resonance imaging (MRI). Rupture of the first dorsal interosseous muscle was misdiagnosed preoperatively as a Stener's lesion in the index finger by ultrasonography. MRI should be an essential differential diagnostic exam for collateral ligament ruptures of the metacarpophalangeal joint of the fingers.
Figures and Tables
Figure 1
Case 1. (A) Ruptured radial collateral ligament (arrows) protruded outside the sagittal band in the fifth metacarpophalangeal joint in T2-weighted fat-suppression magnetic resonance imaging. (B) The arrow indicates a ruptured collateral ligament outside the sagittal band.
Figure 2
Case 2. (A) Proton-density fat-suppression magnetic resonance imaging shows the ruptured radial collateral ligament (arrows) outside the sagittal band in the fifth finger, which was observed intraoperatively (B).
Figure 3
T2-weighted fat-suppression magnetic resonance imaging of case 3 shows a ruptured radial collateral ligament (arrows) lying under the sagittal band (dotted arrows).
Figure 4
Case 4. (A) A soft tissue mass (arrows) is observed in the radial side of the metacarpophalangeal joint of the index finger on ultrasonography. (B) Intact radial collateral ligament is retracted by a hook retractor and distal insertion of the first dorsal interosseous muscle (arrow) is ruptured, retracted, and adhered to the sagittal band. RCL, radial collateral ligament.
References
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