MRI of the Elbow: Interpretation of Common Orthopaedic Injuries

Abstract

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 .

The Iatrogenic Potential of Words

“…T o the Editor: The review "Magnetic Resonance Imaging of the Shoulder: Interpretation of Common Orthopaedic Injuries" is a useful example of the gap between how orthopaedic surgeons and radiologists use words and the way those same words are generally defined and used. 1 The Cambridge Dictionary (https://dictionary.cambridge.org) defines injury as "physical harm or damage to someone's body caused by an accident or an attack." The majority of shoulder pathophysiologies addressed in the review are not injuries.…”

“…To the Editor: The review “Magnetic Resonance Imaging of the Shoulder: Interpretation of Common Orthopaedic Injuries” is a useful example of the gap between how orthopaedic surgeons and radiologists use words and the way those same words are generally defined and used. 1…”