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Computed tomography (CT) and cone-beam CT (CBCT) provide detailed analysis of osseous structures. High-resolution dynamic ultrasound (US) is the preferred technique for soft tissue assessment, while high-resolution magnetic resonance imaging (MRI) offers comprehensive visualization of all anatomical elements with excellent spatial resolution. This educational review describes the pathology of the thumb MCPJ through various imaging modalities, details injury mechanisms, and highlights the role of imaging in diverse conditions such as ulnar collateral ligament (UCL) and radial collateral ligament (RCL) injuries and instabilities, trigger thumb, pulley system lesions, dislocations, osteoarthritis, fractures of the proximal phalanx (P1) head or base, sesamoid disorders, volar plate lesions, rheumatic diseases, and osseous or soft-tissue tumors. Practical recommendations are provided to emphasize the clinical relevance of imaging findings and offer clear guidance for their application in patient care. Early and precise diagnosis is crucial for appropriate management, thereby preventing long-term complications such as instability, osteoarthritis, and functional decline.<\/jats:p>","DOI":"10.1055\/a-2830-5647","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T22:51:18Z","timestamp":1776379878000},"source":"Crossref","is-referenced-by-count":0,"title":["Thumb Metacarpophalangeal Joint \u2013 Part II: Pathologies and Imaging Findings"],"prefix":"10.1055","author":[{"given":"Hicham","family":"Bouredoucen","sequence":"additional","affiliation":[{"name":"H\u00f4pitaux Universitaires Gen\u00e8ve, Switzerland","place":["Geneva"],"department":["Imaging and Medical Informatics"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lokmane","family":"Taihi","sequence":"additional","affiliation":[{"name":"Cliniques universitaires Saint-Luc, Brussels, Belgium","place":["Brussels"],"department":["Medical Imaging"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1055\/a-2834-3432","article-title":"Thumb Metacarpophalangeal Joint. 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