ACR Appropriateness Criteria® Chronic Elbow Pain

Thomas, Jonelle M.; Chang, Eric Y.; Ha, Alice S.; Bartolotta, Roger J.; Bucknor, Matthew; Caracciolo, Jamie T.; Chen, Karen C.; Flug, Jonathan A.; Kumaravel, Manickam; Raizman, Noah; Ross, Andrew B.; Silvis, Matthew; Surasi, Devaki Shilpa; Beaman, Francesca D.

doi:10.1016/j.jacr.2022.09.022

Cited by 4 publications

(5 citation statements)

References 61 publications

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“…The annular ligament, encircling the head of the radius, maintains the proper relationship between the radius and ulna during rotational movements. Injuries are more common in the setting of an acute event, such as elbow dislocation, with overuse-related conditions being somewhat more uncommon than in the medial compartment [ 10 ]. A comprehensive understanding of the capsule and ligamentous structures is imperative for radiologists, as it forms the foundation for accurate interpretation of CT arthrography, aiding in the diagnosis of traumatic injuries, instability, and pathological conditions affecting the elbow joint.…”

Section: Anatomymentioning

confidence: 99%

“…While magnetic resonance (MR) and MR arthrography are widely regarded as the reference standard for nonoperative elbow imaging owing to high sensitivity and specificity [ 7 , 8 , 9 , 10 ], CT arthrography represents a valuable complementary diagnostic tool for addressing a variety of clinical queries [ 11 ]. The use of multichannel detector arrays, the availability of submillimeter-thick slices, and new methods to reduce metal-related beam hardening artifacts, has enabled the examination of joints with remarkable precision, particularly by allowing isotropic multiplanar imaging reformatting with excellent spatial resolution.…”

Section: Introductionmentioning

confidence: 99%

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CT Arthrography of the Elbow: What Radiologists Should Know

Folco,

Messina,

Gitto

et al. 2024

Tomography

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Computed tomography (CT) arthrography is a quickly available imaging modality to investigate elbow disorders. Its excellent spatial resolution enables the detection of subtle pathologic changes of intra-articular structures, which makes this technique extremely valuable in a joint with very tiny chondral layers and complex anatomy of articular capsule and ligaments. Radiation exposure has been widely decreased with the novel CT scanners, thereby increasing the indications of this examination. The main applications of CT arthrography of the elbow are the evaluation of capsule, ligaments, and osteochondral lesions in both the settings of acute trauma, degenerative changes, and chronic injury due to repeated microtrauma and overuse. In this review, we discuss the normal anatomic findings, technical tips for injection and image acquisition, and pathologic findings that can be encountered in CT arthrography of the elbow, shedding light on its role in the diagnosis and management of different orthopedic conditions. We aspire to offer a roadmap for the integration of elbow CT arthrography into routine clinical practice, fostering improved patient outcomes and a deeper understanding of elbow pathologies.

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Section: Anatomymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

CT Arthrography of the Elbow: What Radiologists Should Know

Folco,

Messina,

Gitto

et al. 2024

Tomography

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“…An elbow MRI without contrast also received the highest rating for assessment of occult fractures, chronic epicondylitis, distal biceps tendon tears, and nerve abnormalities. 2 A full review of a normal elbow MRI is available in the supplemental online materials (Video 1, A Systematic Approach to Elbow MRI Interpretation).…”

Section: Indications For Elbow Mrimentioning

confidence: 99%

MRI of the Elbow: Interpretation of Common Orthopaedic Injuries

Stanborough

Wessell

Elhassan

et al. 2021

J Am Acad Orthop Surg

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MRI is a valuable diagnostic tool that has become an essential part of an orthopaedic surgeon's practice. When acquired in the appropriate clinical setting, an MRI can direct patient management as surgical versus nonsurgical, guide surgical decision making, and even predict patient outcomes. The quality of MRI obtained and quality of the radiology report received varies. Ultimately, the orthopaedic surgeon must interpret the available imaging and apply these findings to treat the patient. The current day practicing orthopaedic surgeon should be familiar with interpreting common MRIs. Although subspecialized orthopaedic surgeons usually have experience and understanding of MRIs in their field, the general orthopaedic surgeon and those intraining will encounter the gamut of musculoskeletal MRIs. This review focuses on common injuries that can occur in the elbow and provides an approach to minimize missed findings. E lbow pain is a common report addressed by both general and subspecialized orthopaedic surgeons. Clinical examination and radiographs are often sufficient to diagnose most conditions. Although radiographs provide information on bone/joint integrity and alignment, soft-tissue evaluation is particularly limited. When concerned for soft-tissue pathology, MRI can be useful to guide conservative versus surgical treatment. The goal of this review is to provide a reference for the general orthopaedic surgeon and those in-training to interpret the MRI findings of common elbow conditions. This review is not meant to be exhaustive of all elbow pathology. Learning how to interpret elbow MRIs can improve patient care by correlating clinical findings with MRI findings and recognizing salient details not always found in the radiologist report 1 .

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“…Chronic elbow pain is a significant concern for patients in clinical settings. Symptoms often reported by patients include swelling, pain, restricted mobility, stiffness, and neurological disturbances such as numbness [7]. The causes of chronic elbow pain are diverse, ranging from anomalies in bones, soft tissues, and nerves.…”

Section: Introductionmentioning

confidence: 99%

“…The development of conditions like epicondylitis is influenced by both occupational and recreational activities, underscoring the multifactorial nature of its etiology [5,6,12]. In addition to epicondylitis, other common pathologies associated with the elbow joint include nerverelated conditions such as cubital tunnel syndrome, radial tunnel syndrome, and pronator teres syndrome [7]. Traumatic injuries, including dislocations, ligament injuries, and fractures around the elbow joint, are also included [13].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology and Etiology of Elbow Pain Based on the Healthcare Bigdata Hub in Korea: A Longitudinal Observational Study

Kim,

Jang

2023

Ewha Med J

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This study investigated the epidemiological and etiological trends associated with elbow pain over the past decade in South Korea. Methods: Nationwide health statistics data from 2011 to 2020 pertaining to elbow pain-related diseases and soft tissue damages were sourced from the Healthcare Bigdata Hub with disease codes M771 (lateral epicondylitis), M770 (medial epicondylitis), S53 (elbow injury, dislocation, sprain), and G56 (mononeuropathies of the upper limb). The study assessed the annual fluctuations in the total medical cost and the number of patients associated with these codes. Trends over time were characterized by evaluating the crude and age-standardized prevalence rates and the annual percentage change. Changes in the proportion of medical expenses based on age distribution were also investigated. Results: A significant surge in medical costs was observed across all four codes. The M771, M770, and G56 codes experienced a pronounced increase in crude and age-standardized prevalence. Conversely, only S53 registered a significant drop in age-standardized prevalence. Moreover, within the total medical expenditures for the M771 code, the age bracket of 50 to 59 represented the largest proportion. Conclusion:The data suggest that the average age of patients reporting elbow pain is rising. Given this shifting trend in South Korea's health statistics concerning elbow pain, there will be an increasing need for socioeconomic support, which will in turn necessitate improving health policies that address allocating medical expenses and resources for elbow pain.

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ACR Appropriateness Criteria® Chronic Elbow Pain

Cited by 4 publications

References 61 publications

CT Arthrography of the Elbow: What Radiologists Should Know

CT Arthrography of the Elbow: What Radiologists Should Know

MRI of the Elbow: Interpretation of Common Orthopaedic Injuries

Epidemiology and Etiology of Elbow Pain Based on the Healthcare Bigdata Hub in Korea: A Longitudinal Observational Study

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