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Sonographic diagnosis of an acute Stener lesion: a case report.

ABSTRACT: This case report describes the use of diagnostic ultrasound to diagnose a Stener lesion in a patient who presented for conservative care of thumb pain following a fall on an outstretched hand. Conventional radiographic images demonstrated an avulsion fracture at the ulnar aspect of the base of the first proximal phalanx. Diagnostic ultrasound revealed a torn ulnar collateral ligament of the thumb that was displaced proximal to the adductor aponeurosis, consistent with a Stener lesion. Dynamic imaging with ultrasound confirmed displacement of the fully torn ligament. Surgical repair followed the diagnosis. Diagnostic ultrasound in this case provided an accurate diagnosis obviating further imaging. This allowed an optimal outcome due to early intervention.

SUBMITTER: Mattox R

PROVIDER: S-EPMC4879008 | biostudies-other | 2016

REPOSITORIES: biostudies-other

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Sonographic diagnosis of an acute Stener lesion: a case report.

Mattox Ross R Welk Aaron B AB Battaglia Patrick J PJ Scali Frank F Nunez Mero M Kettner Norman W NW

Journal of ultrasound 20150623 2

This case report describes the use of diagnostic ultrasound to diagnose a Stener lesion in a patient who presented for conservative care of thumb pain following a fall on an outstretched hand. Conventional radiographic images demonstrated an avulsion fracture at the ulnar aspect of the base of the first proximal phalanx. Diagnostic ultrasound revealed a torn ulnar collateral ligament of the thumb that was displaced proximal to the adductor aponeurosis, consistent with a Stener lesion. Dynamic im ...[more]

PMID: 27298646

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Project description:IntroductionUrorectal septum malformation sequence (URSMS) is a rare congenital abnormal syndrome that is caused by the incomplete division of the cloaca. Based on whether the cloaca membrane breaks down or not, the URSMS are classified as full and partial forms. The prenatal diagnosis of URSMS remains challenging because of poor recognition to this malformation and the relatively non-specific sonographic features. We report a prenatally sonographic diagnosed case of the partial URSMS, and review the literature to summarize the prenatal features.Case report and reviewA 37-year old woman was referred at 24 weeks of gestation for fetal abdominal cyst. Detailed sonographic examination was done and revealed the vesicocolic fistula, distended colon, absence of perianal hypoechoic ring, pyelectasis, and small stomach bubble. The URSMS was suspected.Amniocentesis was done and karyotyping revealed 46,XY. Furthermore, chromosomal microarray analysis (CMA) was performed for the first time in URSMS and an alteration of 111.8Kb deletion was detected in 16p13.3 which was located inside the RBFOX1 gene. Parental studies showed that the deletion was inherited from the father who has nomal clinical phenotype.The woman elected to terminate the pregnancy at 25 weeks gestation and postmortem examination confirmed the diagnosis of partial URSMS.The published studies were reviewed and 28 cases of URSMS with conducted prenatal ultrasonography were collected in this report. The most common sonographic description, as suspicious signs of URSMS, were severe oligohydramnios or anhydramnios, urinary tract anomalies, fetal intra-abdominal cysts, and dilated bowel. Also, enterolithiasis and vesicocolic fistula were relatively infrequent but highly specific feature of URSMS.ConclusionsURSMS is difficult to be diagnosed prenatally. However, it has characteristic features that can be detected by fetal ultrasonography, and a precise prenatal sonographic examination is crucial for diagnosing URSMS. Besides, more genomic profiling studies are needed to elucidate the causality.

Dataset Information

Sonographic diagnosis of an acute Stener lesion: a case report.

Publications

Sonographic diagnosis of an acute Stener lesion: a case report.

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