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

Hwang, Tae Hyok; Cho, Hyung Lae; Kim, Hyoung Min; Park, Ki Bong; Jo, Hong

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.