Investigation of ligament, bone, synovial and plica pathologies accompanied by common extensor tendon in patients with lateral overuse syndrome of the elbow using magnetic resonance imaging

Abstract

Background Tendinosis in the common extensor tendon and accompanying ligament, bone, and plica abnormalities can be observed on magnetic resonance imaging (MRI). Purpose To determine whether there is a difference between accompanying abnormalities according to the degree of common extensor tendon injury Material and Methods Patients who underwent 1.5-T MRI tests with a prediagnosis of lateral overuse syndrome were retrospectively reviewed, and 56 patients who had an injury in the common extensor tendon (CET) were included. The degree of tendon and ligament injury, muscle signal change, bone marrow signal change, presence of joint effusion, and morphological features in the presence of plica were evaluated via MRI examinations of the elbow. Results Overall, 32, 16, and eight patients had mild, moderate, and severe CET damage, respectively. As the severity of CET damage increased, the presence of joint effusion, and the presence and degree of damage to the lateral ulnar collateral ligament (LUCL) and radial collateral ligament (RCL) increased. The radiohumeral (RH) plica area was significantly larger in the group with mild CET damage. There was no statistically significant correlation between the severity of CET damage and the end of RH plica with a blind-end, coverage of one-third or more of the radius, its signal, thickness, and presence of olecranon fold. Conclusion As the severity of CET injury increases, damage to the LUCL, RCL, and the presence of effusion in the joint increases. RH plica should be evaluated in terms of concomitant pathology in patients with mild CET injuries on MRI.

Ultrasound evaluation shows increase in laxity after partial common extensor origin detachment but not after additional lesion of the radial band of the lateral collateral ligament

“…In the recently developed SMILE model, the role of the R-LCL as a static stabilizer was emphasized, suggesting that patholaxity and elongation of the R-LCL caused by mild, repetitive varus/pronation stresses can lead to relative hypermobility of the radial head, minor incongruence of the proximal radioulnar joint, subsequent intra-articular alterations and finally ECRB tendinopathy and lateral elbow pain [5]. This model is gaining popularity and an increasing number of reports are being published, reporting on MRI findings of R-LCL abnormalities in patients affected by recalcitrant lateral elbow pain [34][35][36][37].…”

“…Magnetic resonance imaging is regarded as a second level diagnostic tool established as gold standard for detecting capsular and ligament lesions [ 36 ]. However, it is expensive, time consuming, and was not available for a biomechanical cadaveric study involving repetitive evaluations and stress testing [ 34 , 35 , 37 ]. Furthermore, magnetic resonance imaging lacks functional and dynamic information, which is an advantage of US techniques.…”

Benefit of Arthroscopy in Differential Diagnostics and Therapy of Lateral Epicondylitis

“…(23) Hypertrofie RH pliky bývá jako příčina bolestí lokte často podceňována. Může být samostatným spouštěčem bolestí na laterální straně lokte nebo může být součástí -a to jako příčina nebo důsledek -laterální epikondylitidy (2).…”

“…Průměrné hodnoty (1)(2)(3)(4)(5) pro jednotlivé body (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) hodnocení QuickDASH s výsledky jednotlivých skupin Table 1. Average values (1)(2)(3)(4)(5) for individual items (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) Náš operační postup -artroskopická revize následovaná otevřenou operací laterální epikondylitidy -podporuje i Riffova revizní studie z roku 2018 (20), která srovnává výsledky artroskopického, perkutánního a otevřeného přístupu při operaci laterální epikondylitidy. Nebyl rozdíl mezi skupinami, kdy se hodnotilo trvání návratu k pracovnímu zařazení, komplikace nebo spokojenost pacientů.…”