title: Gamekeeper thumb: comparison of MR arthrography with conventional arthrography and MR imaging in cadavers.
abstract: OBJECTIVE
  To compare magnetic resonance (MR) arthrography with conventional arthrography and standard MR imaging in the evaluation of gamekeeper thumb.
  
  
  METHODS
  Eighteen cadaveric thumbs with (n = 12) or without (n = 6) experimental abduction stress were examined with conventional arthrography, standard MR imaging, and MR arthrography. Standard MR imaging and MR arthrography were performed with 0.2-T (low-field-strength) extremity-only and 1.5-T (high-field-strength) magnets. Results of blinded imaging analyses were correlated with pathologic findings. Paired MR images and MR arthrograms were rated with a three-point scale.
  
  
  RESULTS
  Fourteen ulnar collateral ligaments were torn, including eight nondisplaced (57%) and six displaced (43%) tears. For the presence of tear, diagnostic accuracy of conventional arthrography, low-field-strength MR imaging, high-field-strength MR imaging, low-field-strength MR arthrography, and high-field-strength MR arthrography was 83%, 89%, 90%, 94%, and 100%, respectively. With regard to displacement of the torn ligament, diagnostic accuracy was 61%, 89%, 90%, 94%, and 100%, respectively. MR arthrograms were rated superior to standard MR images in 72% and 90% of specimens with low-field-strength and high-field-strength magnets, respectively.
  
  
  CONCLUSIONS
  Of the tested methods, MR arthrography proved to be the most sensitive to the diagnosis of a torn ulnar collateral ligament of the first metacarpophalangeal joint and of displacement of the torn ligament.
authors.affiliation: Department of Radiology, Veterans Affairs Medical Center, San Diego, CA 92161, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Ahn
authors.forename: D J
authors.initials: DJ
authors.lastname: Sartoris
authors.forename: H S
authors.initials: HS
authors.lastname: Kang
authors.forename: M J
authors.initials: MJ
authors.lastname: Botte
authors.forename: D
authors.initials: D
authors.lastname: Trudell
authors.forename: P
authors.initials: P
authors.lastname: Haghighi
authors.forename: D
authors.initials: D
authors.lastname: Resnick
mesh_terms: D000368:Aged; D001175:Arthrography; D002102:Cadaver; D017885:Collateral Ligaments / Q000293:injuries* / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007275:Injections, Intravenous; D007472:Iohexol; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000293:injuries*; D012680:Sensitivity and Specificity; D013933:Thumb / Q000293:injuries*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C064925:gadodiamide; D019786:Gadolinium DTPA