Perthes-Like Lesion in Wrist Joint: Stripping of Ulnar Collateral Ligament

Abstract

Background Chronic ulnar-sided wrist pain often proves to be a challenging presenting complaint. A new type of injury to the ulnar collateral ligament (UCL) of the wrist is described in a young female. It is characterized by stripping of UCL from ulnar attachment. Case Description A 32-year-old female sustained an injury after lifting heavy weight. Examination revealed tenderness to the ulnar styloid, terminal radial deviation was painful and decreased grip strength. The arthro-computed tomography (Arthroscanner) diagnosed stripping of ulnar collateral ligament (UCL). The UCL was refixed with transosseous sutures. At one year follow-up, the patient was pain-free with good range of motion and improved grip strength. Literature Review After intense literature review, we found this type of injury was not reported, but we found the same type of injury in the shoulder “Perthes lesion.” Clinical Relevance The UCL stripping of the wrist is a rare entity and undiagnosed on routine investigation. This lesion was only diagnosed on an arthroscanner and was missed on MR study which is commonly used for diagnosed wrist pain. This case is being reported for its rarity and to expand the differential diagnosis of the ulnar-sided wrist pain.