ECU tendon “dislocation” in asymptomatic volunteers

Abstract

Assess extensor carpi ulnaris (ECU) tendon position in the ulnar groove, determine the frequency of tendon "dislocation" with the forearm prone, neutral, and supine, and determine if an association exists between ulnar groove morphology and tendon position in asymptomatic volunteers. Axial proton density-weighted MR was performed through the distal radioulnar joint with the forearm prone, neutral, and supine in 38 asymptomatic wrists. The percentage of the tendon located beyond the ulnar-most border of the ulnar groove was recorded. Ulnar groove depth and length was measured and ECU tendon signal was assessed. 15.8% of tendons remained within the groove in all forearm positions. In 76.3%, the tendon translated medially from prone to supine. The tendon "dislocated" in 0, 10.5, and 39.5% with the forearm prone, neutral and supine, respectively. In 7.9% prone, 5.3% neutral, and 10.5% supine exams, the tendon was 51-99% beyond the ulnar border of the ulnar groove. Mean ulnar groove depth and length were 1.6 and 7.7mm, respectively, with an overall trend towards greater degrees of tendon translation in shorter, shallower ulnar grooves. The ECU tendon shifts in a medial direction when the forearm is supine; however, tendon "dislocation" has not been previously documented in asymptomatic volunteers. The ECU tendon medially translated or frankly dislocated from the ulnar groove in the majority of our asymptomatic volunteers, particularly when the forearm is supine. Overall greater degrees of tendon translation were observed in shorter and shallower ulnar grooves.