The use of ultrasound in the diagnosis of injuries of the ulnar collateralligament of the thumb

We describe the use of a specialist referral clinic and ultrasound assessme nt for all injuries to the ulnar collateral ligament of the metacarpophalan geal joint of the thumb presenting to an Accident and Emergency (A&E) depar tment, Senior House Officers in the A&E department were able to correctly d iagnose only 45% of the ruptures of the ulnar collateral ligament. The over all agreement between specialist clinic examination and ultrasound for inju ry to the ulnar collateral ligament was 85% (kappa 0.647). When compared wi th the operative finding ultrasound had a positive predictive value for rup ture of 94%. An algorithm is presented for the assessment of injuries to th e ulnar collateral ligament in A&E departments.