JBJS JOPA Image Quiz: A Teenager with Thumb Pain After Hand-First Slide

This month’s Image Quiz from the JBJS Journal of Orthopaedics for Physician Assistants (JOPA) describes the case of a 14-year-old boy with a history of a bifid first metacarpal who injured his thumb while sliding hand-first into a base during a baseball game. Anteroposterior and lateral radiographs of the thumb are shown, and findings from the physical exam are detailed in words and photos.

The Image Quiz reviews the function of and injuries to the ulnar collateral ligament (UCL), including the injury classically described as “skier’s thumb.” Pick the best among four possible next steps in diagnosing and treating this injury.