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

Abstract

The elbow is a complex joint whose stability is imparted by osseous and soft-tissue constraints. Anatomical and biomechanical knowledge of the supporting structures that provide stability to the medial and lateral elbow is essential to correctly interpret the pathological findings. Conventional MRI and MR arthrography are the imaging modalities of choice in the evaluation of elbow ligament injuries. Elbow instability can be classified according to timing (acute, chronic, or recurrent), the direction of displacement, the degree of displacement, and the articulations involved. This article reviews the MR imaging protocols recommended for each diagnosis and the normal anatomy and biomechanical aspects of the medial and lateral collateral ligament complex. We also present multiple cases of typical and atypical patterns of injury.

Isolated displaced type II partial articular radial head fracture: correlation of preoperative imaging with intraoperative findings of lateral ulnar collateral ligament tear

“…1 There seems to be little or no value of CT compared with magnetic resonance imaging to depict soft tissue injuries in the acute setting, which makes lateral ligament tear basically an intraoperative finding. [2][3][4][5][6][7][8][9][10][11] Furthermore, information obtained by magnetic resonance imaging has been proven to be ineffective for patient treatment. 16 Assessment of type II articular 2-part RHF is controversial as demonstrated by the several proposed classifications and related prognosis.…”

Evaluation and management of elbow injuries in the adolescent overhead athlete

“… 33 , 34 Additional secondary osseous stabilizers include the radiocapitellar articulation laterally and the olecranon and olecranon fossa posteriorly. 35 , 36 The bony congruity of the olecranon and olecranon fossa serve as the primary restraint to valgus stress with the elbow flexed less than 20° and functions to engage fossa around 20° flexion. 37 Failure of these structures to provide valgus stability may lead to repetitive insults at the elbow and subsequently result in injury.…”

Elbow Imaging with an Emphasis on MRI

“…It provides posterolateral stability for the radiocapitellar joint. The annular ligament runs from the ventral aspect of the radial notch of the ulna around the radial head to attach along with the LUCL along the supinator crest and stabilizes the proximal radioulnar joint [12]. Although these are described as individual structures, studies suggest that they function together as a continuous sheet, rather than as individual entities.…”