Dynamic US of the Anterior Band of the Ulnar Collateral Ligament of the Elbow in Asymptomatic Major League Baseball Pitchers

Nazarian, Levon N.; McShane, John M.; Ciccotti, Michael G.; O’Kane, Patrick; Harwood, Marc I.

doi:10.1148/radiol.2271020288

Cited by 187 publications

(209 citation statements)

References 24 publications

Supporting

Mentioning

200

Contrasting

Order By: Relevance

“…It originates from the medial epicondyle and inserts distally at the base of the coronoid process. The anterior band is the primary restraint to valgus stress [10] and originates from the anteroinferior margin of the medial epicondyle inserting onto the sublime tubercle of the ulna. The ulnar nerve passes through the medial intermuscular septum, approximately 8 cm above the medial epicondyle, coursing along a groove in the medial head of triceps.…”

Section: Anatomy and Pathogenesismentioning

confidence: 99%

Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies

et al. 2014

View full text Add to dashboard Cite

In the second part of this review article the management of medial elbow tendinopathy, distal biceps and distal triceps tendinopathy will be discussed. There is a scarcity of publications concerning any of these tendinopathies. This review will summarise the current best available evidence in their management. Medial elbow tendinopathy, also known as Golfer's elbow, is up to 6 times less common than lateral elbow tendinopathy. The tendinopathy occurs in the insertion of pronator teres and flexor carpi radialis. Diagnosis is usually apparent through a detailed history and examination but care must be made to exclude other conditions affecting the ulnar nerve or less commonly the ulnar collateral ligament complex. If doubt exists then MRI/US and electrophysiology can be used. Treatment follows a similar pattern to that of lateral elbow tendinopathy. Acute management is with activity modification and topical NSAIDs. Injection therapy and surgical excision are utilised for recalcitrant cases. Distal biceps and triceps tendinopathies are very rare and there is limited evidence published. Sequelae of tendinopathy include tendon rupture and so it is vital to manage these tendinopathies appropriately in order to minimise this significant complication. Their management and that of partial tears will be considered. INTRODUCTIONThe tendinopathies to the common flexor origin, distal biceps and distal triceps occur much less commonly than lateral elbow tendinopathy. The second part of this two-part review article focuses on these tendinopathies and the current best evidence to manage them.

show abstract

Section: Anatomy and Pathogenesismentioning

confidence: 99%

Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Sasaki et al 22) reported dynamic ultrasonography for evaluating medial joint laxity and medial collateral ligament injury revealed that the medial elbow joint gap and angular deformity was more increased in the dominant arm of 30 male baseball pitchers. Nazarian et al 23) examined the medial collateral ligament of 26 professional baseball players using dynamic ultrasonography, who had no symptoms on their elbow, and revealed both low echogenic lesions or calcification and thick bands on pitchers'…”

Section: Discussionmentioning

confidence: 99%

Valgus Laxity of Elbow Joint in High School Weight Lifters: Ultrasonographic Assessment

Choi

Kim

Park

et al. 2013

Korean J Sports Med

View full text Add to dashboard Cite

We evaluated abnormalities in medial portion of elbow in high-school weightlifter compared with the non weightlifter using a stress radiography and ultrsonography. The experimental group(G1) was 26 high school weightlifters with an average age of 17 years old (range, 16-18 years). The control group (G2) were comprised of 25 age matched general students. Both groups received physical examination, simple and valgus stress radiography and ultrasonography on both side of elbow. Physical examination showed 26.9% (14/52 elbows) tenderness and 19.2% (10/52 elbows) valgus laxity in G1, no tenderness and laxity in G2. There were no differences in medial joint gaps on simple radiography (G1, 3.3 mm, G2, 2.7 mm; p＞0.05), but the valgus stress view showed 5.6±0.8 mm medial joint gap in G1 and 3.8±0.8 mm in G2 (p＜0.001). Ultrasonography in G1, angular deformity was found in 67.3% (36/52) and G2 all in normal (p＜0.01). The horizontal distance was an average 4.9±1.23 mm for the G1 and 3.1±0.78 mm for the G2 (p＜0.001). Vertical distance of the proximal portion of the ulna was average 0.58±0.94 mm for the G1 and 1.59±0.49 mm for the G2 (p＜0.001). In G1, angular deformity of male was 50% (15/30 elbows) and female was 95% (21/22 elbows) (p＜0.001). Change of horizontal and vertical distance were larger in female (p＜0.05). In conclusion, there were increased incidence of medial elbow joint laxity in high school weightlifter, especially in female, regardless of career. Sustained valgus laxity could be prone to ulnar collateral ligament injury and should be evaluated with ultrasonography-assisted dynamic study.

show abstract

“…Studies demonstrating pathological changes in common extensor tendon, ulnar collateral ligament or heel tendon have been reported [10][11][12][13][14] . However, there were limited studies investigating the role of ultrasonography in lateral epicondylitis [1,4,10,12] .…”

Section: Ultramentioning

confidence: 99%

An overview of ultrasonography in lateral epicondylitis: Correlation with disease duration and severity

Boy

Özkan

Külcü

et al. 2015

IJDI

View full text Add to dashboard Cite

The purpose of this study is to make an overview for ultrasonographic features of lateral epicondylitis and to investigate the correlation of these features with clinical findings including disease duration and severity. This prospective study included 42 consecutive patients diagnosed with lateral epicondylitis on clinical examination. Three patients had bilateral involvement, therefore, 45 elbows were examined with ultrasonography. In addition, the asymptomatic contralateral 39 elbows of 39 patients and as a control group, 16 elbows of 16 healthy asymptomatic volunteers were examined. The ultrasonographic features of lateral epicondylitis in common extensor tendon including focal hypoechoic area, heterogenicity, focal areas of calcification, increase or decrease in thickness, partial or complete tear, peritendinous fluid collection and entesophyte were investigated. These findings were compared with the clinical findings including the duration and severity of complaint. Visual analog scale (VAS) was used to evaluate the severity of pain. Fisher exact test and Mann-Whitney U test were used in statistical analysis, and all tests were considered significant at p < .05 in 95% CIs. In the diseased elbows, the most common finding of the lateral epicondylitis was heterogenicity, focal hypoechoic area and entesophyte, respectively. Statistical examination revealed no significant correlation between ultrasonographic findings and duration of the symtoms. There was also no significant correlation between ultrasonographic findings and severity of pain. Ultrasonography can demonstrate well the features of lateral epicondylitis. It could also be helpful to show the extent of the disease. However, ultrasonographic findings do not significantly correlate with duration and severity of the disease clinically.

show abstract

Dynamic US of the Anterior Band of the Ulnar Collateral Ligament of the Elbow in Asymptomatic Major League Baseball Pitchers

Abstract: Dynamic US provides a rapid means for evaluating the anterior band of the UCL in professional baseball pitchers. In pitching arms, this band is thicker, is more likely to have hypoechoic foci and/or calcifications, and demonstrates more laxity with valgus stress.

Cited by 187 publications

References 24 publications

Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies

Tendinopathies Around the Elbow Part 2: Medial Elbow, Distal Biceps and Triceps Tendinopathies

Valgus Laxity of Elbow Joint in High School Weight Lifters: Ultrasonographic Assessment

An overview of ultrasonography in lateral epicondylitis: Correlation with disease duration and severity

Contact Info

Product

Resources

About