Radial Collateral Ligament of the Elbow

Abstract

Objectives An abnormality of the radial collateral ligament (RCL) in the setting of lateral epicondylitis can indicate a poor clinical outcome; therefore, accurate assessment is important. The purpose of this study was to characterize the proximal RCL attachment, or footprint, as seen on sonography using cadaveric dissection correlation and magnetic resonance arthrography. Methods For the first part of this study, 4 cadaveric elbow specimens were imaged with sonography before and after dissection to characterize the RCL. After Institutional Review Board approval with consent waived, 26 consecutive magnetic resonance (MR) arthrograms of the elbow were identified. The sonograms and MR arthrograms were retrospectively reviewed to measure the length of the RCL footprint and its percentage of the combined RCL and common extensor tendon (CET) humeral footprints. Results The mean RCL footprint length and percentage of the combined RCL and CET footprints were 8.4 mm (range, 7.4–10.0 mm) and 54% as measured from the elbow specimen sonograms and 9.1 mm (range, 6.4–12.5 mm) and 54% as measured from the MR arthrograms. The mean RCL footprint length combining data from specimens and MR arthrograms was 8.9 mm (range, 6.4–12.5 mm), covering 54% of the combined RCL and CET footprints. Conclusions The RCL can be differentiated from the CET on sonography with knowledge of the RCL humeral footprint extent, which measured 8.9 mm in length and comprised 54% of the combined RCL and CET footprints.

Ultrasonography versus magnetic resonance imaging in detecting and grading common extensor tendon tear in chronic lateral epicondylitis

“…Our results are in agreement with previous studies which showed that US is a reliable method to evaluate tendino-ligamentous structures of the lateral elbow region and the results of the US assessment are comparable to those of MRI [ 10 – 12 ]…”

No abatement of steroid injections for tennis elbow in Australian General Practice: A 15-year observational study with random general practitioner sampling

“…It is widely accepted that tennis elbow is a diagnosis made on the basis of presenting signs and symptoms, with imaging reserved for cases in which there is a decision to exclude differential diagnoses such as injury of the radial collateral ligament and radio-humeral joint [23, 24]. Ultrasound was the most used imaging modality followed by plain X-ray, though at a rate of 10 per 100 TE cases it would appear that these are not used to make the diagnosis of TE.…”

Ultrasonographic Characteristics of the Common Extensor Tendon of the Elbow in Asymptomatic Individuals: Thickness, Color Doppler Activity, and Bony Spurs

“…Therefore, the 2 included measurements covered not only the CET but also to a varying degree the underlying ligamentous structures (Figure 1B). 14 To what extent the ligamentous structures contribute to the overall thickness measurement depends on the location at the lateral epicondyle where the US is performed. 27 At the anterior portion of the extensor carpi radialis brevis origin, the joint capsule is very thin, whereas at the posterior portion of the extensor carpi radialis brevis, a more robust attachment is formed that includes the joint capsule, annular ligament, and supinator, all intermingled.…”

“…27 At the anterior portion of the extensor carpi radialis brevis origin, the joint capsule is very thin, whereas at the posterior portion of the extensor carpi radialis brevis, a more robust attachment is formed that includes the joint capsule, annular ligament, and supinator, all intermingled. 6,14,27 In this study, the probe was aimed at the central portion/middle part of the CET in an anterior to posterior orientation.…”