Elbow Imaging in Sport: Sports Imaging Series

Abstract

Elbow pain is a frequent presenting symptom in athletes, particularly athletes who throw. The elbow can be injured as a result of acute trauma, such as a direct blow or a fall onto an outstretched hand or from chronic microtrauma. In particular, valgus extension overload during the throwing motion can precipitate a cascade of chronic injuries that can be debilitating for both casual and high-performance athletes. Prompt imaging evaluation facilitates accurate diagnosis and appropriate targeted interventions.

Magnetic resonance imaging of the elbow

“…MR arthrography has higher sensitivity for partial-thickness ligament tears and may show intra-articular contrast insinuating along the medial margin of the sublime tubercle and under the UCL (called T sign due to similarity with the letter T lying on its side) ( Figure 9 ). It is important to remember that the ulnar footprint of the UCL can be several millimetres distal to the articular margin, which can be an imaging pitfall for ligament injuries [ 16 , 55 , 56 ]. Treatment of VEO syndrome initiates with conservative measures like active rest, physiotherapy, and non-steroid anti-inflammatory medication but may require arthroscopy with osteophyte removal and medial corner olecranon osteotomy in refractory cases [ 50 ].…”

The elbow: review of anatomy and common collateral ligament complex pathology using MRI

“…The use of manual shimming and manual prescan can often correct this problem. The use of short-tau inversion recovery for fat suppression or methods of fat/water separation can also be useful [4, 5].…”

“…All sequences are performed with a 12 to 14 cm field of view and a 256 × 192 or 256 × 256 pixels matrix. Axial, sagittal, and coronal images of the elbow are acquired with a 2.5-mm slice thickness and a 0.5-mm section spacing [5]. The collateral ligaments of the elbow are optimally visualized in a 20° posterior oblique coronal plane in relation to the humeral diaphysis with the elbow extended (Fig.…”

“…With fluoroscopic guidance, the joint can be entered laterally over the radial head. Alternatively, a posterior approach has been suggested to avoid the radial collateral ligament complex or a posterolateral approach to also avoid the triceps tendon [5, 8, 10]. Then, 6–10 mL is normally sufficient to adequately distend the joint.…”

“…The first two joints function as a hinge, permitting flexion and extension; the last two joints accomplish the pivot motion of pronation and supination, and are functionally linked to the distal radioulnar joint and the wrist. The physiologic range of motion is 0 to 140° for flexion-extension movements and 0 to 180° for supination-pronation movements [5, 11].…”