The referrer described a small chronic avulsion at the phalangeal insertion of the MCP RCL in outside XRs I don’t haveWithout that information I would have missed it (white arrows)
There is a chronic partial tear at the site of the old avulsion
I’m not sure if the bright focus dorsal to the avulsion fragment is at the margin or just dorsal to the RCL insertion (red arrow)
Cor images show 10 degrees valgus angulation with min relative widening of the lateral joint space
I noticed that there is external rotation of the proximal phalanx with respect to the axis of the metacarpal head
I have not seen this measured, but it seems potentially relevant in the context of chronic partial RCL tear with suggestion of relative radial laxity and rotational malalignment.
Does anyone measure rotational malalignment…does it make sense?
Hilary
