Skip to Main Content

++

INTRODUCTION

++

The elbow joint is a hinge joint with a loose capsule and collateral ligaments. The capsule is situated along the anterior and posterior aspect of the joint, preventing flexion–extension movements, whereas the collateral ligaments prevent medial and lateral movements. The articulating bones include the distal humerus, proximal radius, and ulna. The medial humeral condyle, also known as the trochlea, articulates with the upper end of the ulna known as the coronoid process. The humeroradial part of the joint consists of the capitellum (distal humerus) and head of the radius.

++

The elbow joint is often subject to overuse injuries. Partial or complete tears of tendons such as the biceps tendon are not infrequent and are often an indication of magnetic resonance imaging (MRI) study. Nerve entrapment syndromes around the elbow are often diagnosed clinically and MRI is usually indicated to rule out a lesion that could be within the nerve or causing compression of the nerve. In this chapter, we will discuss some of the common conditions affecting the elbow joint.

++

IMAGING PROTOCOL

++

All imaging should start with radiographs, including anteroposterior and lateral views of the elbow joint (Figure 15-1). While a bony injury might be evident on these views, when no obvious fracture line or misalignment is noticeable, one has to look at the soft tissues to see if there are secondary signs of insult, such as a “sail sign.” This is a triangular density of fat lifted into the field of view by the effusion in the elbow joint (Figure 15-2). There is controversy as to whether an anterior or posterior sail sign is more important. Any sign of a joint effusion, whether anterior or posterior, merits further investigation.

++
Figure 15-1.

Normal elbow. Lateral radiograph of the elbow. Note anterior stripe of fat is adjacent to the distal humerus.

Graphic Jump Location
++
Figure 15-2.

Sail sign. The fat overlying the joint capsule is lifted off due to distension of the joint capsule by joint effusion and appears as a triangular hypodensity proximal to the joint line (arrow).

Graphic Jump Location
++

In our institution, we routinely perform the following MR sequences: coronal T1-weighted, coronal short tau inversion recovery (STIR), axial T1-weighted, axial T2-weighted fat-suppressed, sagittal proton density (PD) weighted fat-suppressed, and sagittal T2-weighted sequences. Further sequences are tailored according to what is seen on initial imaging, and the benefits of using gadolinium (Gd) are weighed against the risks. If an ultrasound-guided biopsy is under consideration we require a Gd-enhanced T1-weighted fat-suppressed sequence to see if enough synovial tissue is visualized to merit an ultrasound-guided biopsy.

++

EPICONDYLITIS

++

Pain at the origin of common flexor or extensor group of tendons is usually termed epicondylitis. ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPhysiotherapy Full Site: One-Year Subscription

Connect to the full suite of AccessPhysiotherapy content and resources including interactive NPTE review, more than 500 videos, Anatomy & Physiology Revealed, 20+ leading textbooks, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPhysiotherapy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.