MRI of the Stener lesion

Nogah Haramati, Nurith Hiller, Jack Dowdle, Mark Jacobson, Charles N. Barax, Ross I. Lieberfarb, Benisse Lester, Roy G. Kulick

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective. To assess the utility of MR in detecting surgically induced Stener lesions (displaced thumb ulnar collateral ligaments) in cadaveric models. Design. Six cadaver thumbs had ulnar collateral ligament (UCL) tears created surgically. MR examinations (2D STIR and 3D GRASS) were performed identically on all specimens both before displacement (non-Stener) and after displacement (Stener lesion) of the UCL. The MR images were then randomly numbered. Each image was evaluated separately in blinded fashion by four musculoskeletal radiologists for the presence or absence of a Stener lesion. Each radiologist reinterpreted the images after an interval of several days. The interpretation was based on previously published criteria for Stener lesion diagnosis by MR. Results. The sensitivity of GRASS ranged from 0.17 to 0.67 with the most experienced reader scoring the lowest. The specificity of GRASS ranged from 0.33 to 1.0 (most experienced reader 0.67, 0.83). STIR had a sensitivity of 0.00-0.17 and a specificity of 0.53-0.83. The κ values for inter- and intraobserver agreement were measured. The intraobserver κ for GRASS was 0.27-0.75 (most experienced reader 0.75). Conclusions. 2D imaging is probably inadequate for the evaluation of Stener lesions. The most likely reason is that the STIR slice thickness of 3 mm limits resolution of small UCLs. The poor sensitivity and specificity of GRASS as well as poor interobserver agreement suggest that MR may not be sufficiently accurate for Stener lesion evaluation.

Original languageEnglish (US)
Pages (from-to)515-518
Number of pages4
JournalSkeletal Radiology
Volume24
Issue number7
DOIs
StatePublished - Oct 1995

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Thumb
Cadaver
Sensitivity and Specificity
Ulnar Collateral Ligament
Radiologists

Keywords

  • Gamekeeper's thumb
  • Magnetic resonance tomography
  • Metacarpophalangeal joint
  • Stener lesion
  • STIR
  • Ulnar collateral ligament

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

Cite this

Haramati, N., Hiller, N., Dowdle, J., Jacobson, M., Barax, C. N., Lieberfarb, R. I., ... Kulick, R. G. (1995). MRI of the Stener lesion. Skeletal Radiology, 24(7), 515-518. https://doi.org/10.1007/BF00202149

MRI of the Stener lesion. / Haramati, Nogah; Hiller, Nurith; Dowdle, Jack; Jacobson, Mark; Barax, Charles N.; Lieberfarb, Ross I.; Lester, Benisse; Kulick, Roy G.

In: Skeletal Radiology, Vol. 24, No. 7, 10.1995, p. 515-518.

Research output: Contribution to journalArticle

Haramati, N, Hiller, N, Dowdle, J, Jacobson, M, Barax, CN, Lieberfarb, RI, Lester, B & Kulick, RG 1995, 'MRI of the Stener lesion', Skeletal Radiology, vol. 24, no. 7, pp. 515-518. https://doi.org/10.1007/BF00202149
Haramati N, Hiller N, Dowdle J, Jacobson M, Barax CN, Lieberfarb RI et al. MRI of the Stener lesion. Skeletal Radiology. 1995 Oct;24(7):515-518. https://doi.org/10.1007/BF00202149
Haramati, Nogah ; Hiller, Nurith ; Dowdle, Jack ; Jacobson, Mark ; Barax, Charles N. ; Lieberfarb, Ross I. ; Lester, Benisse ; Kulick, Roy G. / MRI of the Stener lesion. In: Skeletal Radiology. 1995 ; Vol. 24, No. 7. pp. 515-518.
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abstract = "Objective. To assess the utility of MR in detecting surgically induced Stener lesions (displaced thumb ulnar collateral ligaments) in cadaveric models. Design. Six cadaver thumbs had ulnar collateral ligament (UCL) tears created surgically. MR examinations (2D STIR and 3D GRASS) were performed identically on all specimens both before displacement (non-Stener) and after displacement (Stener lesion) of the UCL. The MR images were then randomly numbered. Each image was evaluated separately in blinded fashion by four musculoskeletal radiologists for the presence or absence of a Stener lesion. Each radiologist reinterpreted the images after an interval of several days. The interpretation was based on previously published criteria for Stener lesion diagnosis by MR. Results. The sensitivity of GRASS ranged from 0.17 to 0.67 with the most experienced reader scoring the lowest. The specificity of GRASS ranged from 0.33 to 1.0 (most experienced reader 0.67, 0.83). STIR had a sensitivity of 0.00-0.17 and a specificity of 0.53-0.83. The κ values for inter- and intraobserver agreement were measured. The intraobserver κ for GRASS was 0.27-0.75 (most experienced reader 0.75). Conclusions. 2D imaging is probably inadequate for the evaluation of Stener lesions. The most likely reason is that the STIR slice thickness of 3 mm limits resolution of small UCLs. The poor sensitivity and specificity of GRASS as well as poor interobserver agreement suggest that MR may not be sufficiently accurate for Stener lesion evaluation.",
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AU - Lieberfarb, Ross I.

AU - Lester, Benisse

AU - Kulick, Roy G.

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N2 - Objective. To assess the utility of MR in detecting surgically induced Stener lesions (displaced thumb ulnar collateral ligaments) in cadaveric models. Design. Six cadaver thumbs had ulnar collateral ligament (UCL) tears created surgically. MR examinations (2D STIR and 3D GRASS) were performed identically on all specimens both before displacement (non-Stener) and after displacement (Stener lesion) of the UCL. The MR images were then randomly numbered. Each image was evaluated separately in blinded fashion by four musculoskeletal radiologists for the presence or absence of a Stener lesion. Each radiologist reinterpreted the images after an interval of several days. The interpretation was based on previously published criteria for Stener lesion diagnosis by MR. Results. The sensitivity of GRASS ranged from 0.17 to 0.67 with the most experienced reader scoring the lowest. The specificity of GRASS ranged from 0.33 to 1.0 (most experienced reader 0.67, 0.83). STIR had a sensitivity of 0.00-0.17 and a specificity of 0.53-0.83. The κ values for inter- and intraobserver agreement were measured. The intraobserver κ for GRASS was 0.27-0.75 (most experienced reader 0.75). Conclusions. 2D imaging is probably inadequate for the evaluation of Stener lesions. The most likely reason is that the STIR slice thickness of 3 mm limits resolution of small UCLs. The poor sensitivity and specificity of GRASS as well as poor interobserver agreement suggest that MR may not be sufficiently accurate for Stener lesion evaluation.

AB - Objective. To assess the utility of MR in detecting surgically induced Stener lesions (displaced thumb ulnar collateral ligaments) in cadaveric models. Design. Six cadaver thumbs had ulnar collateral ligament (UCL) tears created surgically. MR examinations (2D STIR and 3D GRASS) were performed identically on all specimens both before displacement (non-Stener) and after displacement (Stener lesion) of the UCL. The MR images were then randomly numbered. Each image was evaluated separately in blinded fashion by four musculoskeletal radiologists for the presence or absence of a Stener lesion. Each radiologist reinterpreted the images after an interval of several days. The interpretation was based on previously published criteria for Stener lesion diagnosis by MR. Results. The sensitivity of GRASS ranged from 0.17 to 0.67 with the most experienced reader scoring the lowest. The specificity of GRASS ranged from 0.33 to 1.0 (most experienced reader 0.67, 0.83). STIR had a sensitivity of 0.00-0.17 and a specificity of 0.53-0.83. The κ values for inter- and intraobserver agreement were measured. The intraobserver κ for GRASS was 0.27-0.75 (most experienced reader 0.75). Conclusions. 2D imaging is probably inadequate for the evaluation of Stener lesions. The most likely reason is that the STIR slice thickness of 3 mm limits resolution of small UCLs. The poor sensitivity and specificity of GRASS as well as poor interobserver agreement suggest that MR may not be sufficiently accurate for Stener lesion evaluation.

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