MRI of the Annular Ligament of the Elbow: Review of Anatomic Considerations and Pathologic Findings in Patients With Posterolateral Elbow Instability

Mak, Serena; Beltrán, Luis; Bencardino, Jenny T.; Orr, J.A.; Jazrawi, Laith M.; Cerezal, Luís; Beltran, Javier

doi:10.2214/ajr.13.12263

Cited by 33 publications

(23 citation statements)

References 35 publications

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“…Современные исследования позволили прояснить и ряд факторов, обусловливающих развитие ПГЛ именно у детей младшего возраста. У детей до 5 лет фиксация анулярной связки к надкостнице шейки лучевой кости очень слаба, особенно в переднем отделе, что способствует ее отрыву и последующему смещению [3,19]. Ядро окостенения в проксимальном метафизе лучевой кости появляется только в промежутке между 3 и 5 годами.…”

Section: этиология и патогенезunclassified

Current views on radial head subluxation

Petrushin

Леонидович²,

Bragina

et al. 2020

Pediatr Traum Orthop Reconstr Surg

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Backgrоund. Radial head subluxation is the most common injury in young children and accounts for 2.6% of the total population in this age group. In 39%82% of cases, the mechanism of injury is the traction of the arm, but subluxation can occur during a fall and in other circumstances; in 19%51% of cases, the mechanism of injury is unknown. Aim. The purpose of this study is to generalize and arrange the available literature and data and present current views on the prevalence, etiology, pathogenesis, diagnosis, and treatment of radial head subluxation in children. Materials and methods. A literature search was performed using the PubMed, PubMed Central, Google Scholar, CNKI-Scholar, Cyberleninka, and eLibrary databases. The sample of sources was mainly limited to 20002019. Results. The cause of subluxation is the displacement of the annular ligament and its interposition in the humeroradial joint. It is determined by a number of features of the elbow joint anatomy in young children. Diagnosis of radial head subluxation is based on history and clinical data; radiography and ultrasonography are used to obtain a clear clinical picture and to exclude fractures. The mainstay of treatment is a closed reduction, which is conducted via two methods as follows: supinationflexion and hyperpronation. According to modern research data, preference is given to the hyperpronation method; it is more effective in terms of number of reduction attempts, is technically simpler and, possibly, less painful. Generally, immobilization after effective reduction is not required as the function of the elbow joint is fully restored. A consequence of radial head subluxation is recurrence, which occurs in 5%46% of cases. A factor associated with recurrence is being less than two years of age. The prophylaxis of radial head subluxation is aimed at preventing forceful arm traction in children under three years of age and involves educating the parents or caregivers in the symptoms of subluxation to prevent late admission. Conclusions. Radial head subluxation is found in young children and is mainly diagnosed clinically. The treatment consists of a closed reposition, and the prognosis for restoring limb function is favorable.

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Section: этиология и патогенезunclassified

Current views on radial head subluxation

Petrushin

Леонидович²,

Bragina

et al. 2020

Pediatr Traum Orthop Reconstr Surg

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“…Most often, it is associated with a larger injury to the LUCL complex, including varus elbow stress, elbow dislocation, and PLRI. However, in pediatric population, dislocation and rupture of the AL can be seen in the setting of nursemaid elbow and Monteggia fracture [36]. The AL is best visualized on axial and sagittal MR imaging using standard sequences and field strength.…”

Section: Ligamentous Pathologymentioning

confidence: 99%

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

et al. 2019

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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.

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“…The lateral ulnar collateral ligament (LUCL) is the major posterolateral stabilizer and can be seen on coronal or sagittal images, arising more posteriorly and superficially from the lateral epicondyle, and inserting onto the supinator crest. 1,3 Numerous muscles originate at or insert into the osseous surfaces of the elbow. 4 They can be divided into anterior, posterior, medial, and lateral compartments ( Table 3).…”

Section: Figs 2 and 7)mentioning

confidence: 99%

“…10). 3,8 The most significant complications are recurrence and arthrosis; others include infection, bony bridge fracture, cutaneous nerve injury, and arthrofibrosis that results in a flexion contracture. 10 …”

Section: Posterolateral Rotatory Instabilitymentioning

confidence: 99%