Diagnosis of an ulnar collateral ligament tear using musculoskeletal ultrasound in a collegiate baseball pitcher: a case report

OBJECTIVETo demonstrate a comparative diagnostic approach between magnetic resonance imaging (MRI) and musculoskeletal ultrasound for detecting UCL trauma of the elbow in a collegiate baseball pitcher. BACKGROUNDA 19 year-old male baseball pitcher with no previous history of an elbow injury presente...

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Bibliographic Details
Published in:North American journal of sports physical therapy : NAJSPT 2010, Vol.5 (4), p.227-233
Main Authors: Wood, Nate, Konin, Jeff G, Nofsinger, Charles
Format: Report
Language:English
Online Access:Get full text
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Summary:OBJECTIVETo demonstrate a comparative diagnostic approach between magnetic resonance imaging (MRI) and musculoskeletal ultrasound for detecting UCL trauma of the elbow in a collegiate baseball pitcher. BACKGROUNDA 19 year-old male baseball pitcher with no previous history of an elbow injury presented with left medial elbow pain after experiencing a popping sensation during a bull pen throwing session. Patient initially demonstrated palpable tenderness directly over the UCL and a positive milking maneuver. Minimal swelling and no observable discoloration were noted upon examination. Diagnostic ultrasound was utilized to assess the elbow anatomical structures. The differential diagnosis included medial epicondylitis, flexor pronator muscle strain, ulnar collateral ligament tear TREATMENTInitial treatment was conservative while preparing for a ligament reconstruction. Goals included pain control, restoration of range of motion, and reduction of inflammation. UNIQUENESSAccurate diagnosis of UCL disruption was made using dynamic diagnostic musculoskeletal ultrasound despite a negative MRI. The ability to accurately identify the injury contributed to the timeliness of the appropriate surgical intervention and the facilitation of a timely and successful rehabilitation program. CONCLUSIONSDynamic musculoskeletal ultrasound may offer an effective option for diagnosing UCL tears of the elbow. Diagnostic musculoskeletal ultrasound is an affordable, accessible, and portable option that provides a clinician with real-time information and accurate observations in the hands of a skilled operator. Diagnostic musculoskeletal ultrasound may play an increased role as a diagnostic tool in the sports medicine community.
ISSN:1558-6170