Sonography of the Lateral Ulnar Collateral Ligament of the Elbow: Study of Cadavers and Healthy Volunteers

Stewart, Brian G.; Harish, Srinivasan; Oomen, Glen; Wainman, Bruce; Popowich, Terry; Moro, Jaydeep

doi:10.2214/ajr.09.2812

Cited by 30 publications

(22 citation statements)

References 18 publications

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“…15,16 Special care was taken not to introduce any portion of the elbow's collateral ligamentous complex in the measurements of tendon thickness (TT), particularly the lateral ulnar collateral ligament, which is intimately associated with the deepest fibers of the CET. 17 When the structure was considered pathologic, it was assigned to one of the following progressive pathologic categories: grade 1, hypo echogenicity of the tendon with a conserved fibrillar structure and no other lesions; grade 2, appearance of more-hypoechoic regions up to 2 mm in diameter where the fibrillar structure was lost; grade 3, more-hypoechoic regions between 2 and 5 mm in diameter with no fibrillar structure; and grade 4, more-hypoechoic regions larger than 5 mm in diameter or clearly anechoic. The affected region in the tendon was classified as diffuse or generalized if it affected the whole width of the tendon or localized if it only affected part of the tendon (in this case, the affected region was classified as radial, middle, or cubital in the transverse plane).…”

Section: Type Of Activity Examplesmentioning

confidence: 99%

Sonographic Findings for the Common Extensor Tendon of the Elbow in the General Population

Jaén-Díaz¹,

Cerezo-López²,

Castro

et al. 2010

Journal of Ultrasound in Medicine

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Objective. To describe structural characteristics and sonographic alterations of the common extensor tendon (CET). Methods. In 240 patients, we determined the body mass index; sonographic CET thickness, morphologic characteristics, and alterations; and color Doppler measurements of the epicondylar artery width and peak systolic velocity. Age, sex, epicondylalgia history, activities (work, sports, and hobbies), and dominant and nondominant elbows were noted. . Thickness correlated weakly with age (dominant, r = 0.284; nondominant, r = 0.215) and moderately with weight (dominant, r = 0.492; nondominant, r = 0.502). The mean epicondylar artery diameter was 1.35 mm (SD, 0.96 mm); mean peak velocity, 13.01 cm/s (SD, 4.90 cm/s). Morphologic abnormalities were found in 79.5% of patients with a history of epicondylalgia; 7.7% with no history had abnormalities; and 55.9% with abnormalities but no history were older than 55 years. Bone spurs (49.2% versus 16.4% [P < .001]), tendon calcifications (21.5% versus 3.9% [P < .001]), and bone cortex abnormalities (12.3% versus 1.7% [P < .001]) were found more often in non-normal elbows; 79.4% of bone spurs in normal elbows occurred in patients older than 55 years. Conclusions. Mild sonographic alterations in the CET and bone spurs should be considered with caution when assessing epicondylar pain, especially in patients older than 55 years and those with a history of epicondylalgia.

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Section: Type Of Activity Examplesmentioning

confidence: 99%

Sonographic Findings for the Common Extensor Tendon of the Elbow in the General Population

Jaén-Díaz¹,

Cerezo-López²,

Castro

et al. 2010

Journal of Ultrasound in Medicine

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“…7). The proximal part of the LUCL also inserts on the humerus in the same area as the RCL but somewhat more toward the radial side [4,5]. Typically, however, the LUCL and RCL cannot be separated along their proximal course.…”

Section: Lateral Ligamentsmentioning

confidence: 99%

Ultrasound of the elbow with emphasis on detailed assessment of ligaments, tendons, and nerves

Maeseneer

Brigido

Antić

et al. 2015

European Journal of Radiology

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a b s t r a c tThe high resolution and dynamic capability of ultrasound make it an excellent tool for assessment of superficial structures. The ligaments, tendons, and nerves about the elbow can be fully evaluated with ultrasound. The medial collateral ligament consists of an anterior and posterior band that can easily be identified. The lateral ligament complex consists of the radial collateral ligament, ulnar insertion of the annular ligament, and lateral ulnar collateral ligament, easily identified with specialized probe positioning. The lateral ulnar collateral ligament can best be seen in the cobra position. On ultrasound medial elbow tendons can be followed nearly up to their common insertion. The pronator teres, flexor carpi radialis, palmaris longus, and flexor digitorum superficialis can be identified. The laterally located brachioradialis and extensor carpi radialis longus insert on the supracondylar ridge. The other lateral tendons can be followed up to their common insertion on the lateral epicondyle. The extensor digitorum, extensor carpi radialis brevis, extensor digiti minimi, and extensor carpi ulnaris can be differentiated. The distal biceps tendon is commonly bifid. For a complete assessment of the distal biceps tendon specialized views are necessary. These include an anterior axial approach, medial and lateral approach, and cobra position. In the cubital tunnel the ulnar nerve is covered by the ligament of Osborne. Slightly more distally the ulnar nerve courses between the two heads of the flexor carpi ulnaris. An accessory muscle, the anconeus epitrochlearis can cover the ulnar nerve at the cubital tunnel, and is easily identified on ultrasound. The radial nerve divides in a superficial sensory branch and a deep motor branch. The motor branch, the posterior interosseous nerve, courses under the arcade of Frohse where it enters the supinator muscle. At the level of the dorsal wrist the posterior interosseous nerve is located at the deep aspect of the extensor tendons. The median nerve may be compressed at various sites, including the lacertus fibrosis, between the pronator teres heads, and the sublimis bridge. These compression sites can be identified with ultrasound.

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“…The proximal attachment can be identifi ed in 94 % of asymptomatic people and the distal attachment in 90 % [ 44 ]. The normal ligament should be more echogenic than muscle; tears appear hypoechoic (the contralateral side can also be studied to clarify questionable cases).…”

Section: Imagingmentioning

confidence: 99%

The Elbow and Forearm: Acquired Disorders

Uhl

2014

Pediatric Orthopedic Imaging

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This chapter fi rst discusses the timing of ossifi cation of the apophyses and epiphyses at the elbow, as an understanding of the appearance of the normal elbow is essential to correct interpretation of the pediatric elbow radiograph. It then discusses fractures that are common in younger children, such as supracondylar, lateral condylar, and medial condylar fractures. It presents radial neck and olecranon fractures, generally encountered in the adolescent period. The many injuries that result from valgus stress are then discussed, including osteochondritis dissecans of the capitellum and medial epicondylar apophysitis. The chapter concludes with a presentation of osteochondrosis of the capitellum (Panner disease).Fractures and overuse injuries are common in the pediatric elbow. Supracondylar, lateral condylar, and medial condylar fractures are especially common in younger children, often due to falls. After these centers fuse, physeal injuries no longer occur; radial neck fractures and olecranon fractures become more common in the adolescent period. Repetitive valgus stress-such as occurs in pitchers and other throwing athletesmay lead to osteochondritis dissecans of the capitellum, apophysitis of the medial epicondyle or olecranon, loose bodies, and growth disturbances.

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Sonography of the Lateral Ulnar Collateral Ligament of the Elbow: Study of Cadavers and Healthy Volunteers

Abstract: High-resolution ultrasound imaging is accurate for identification and measurement of normal lateral ulnar collateral ligaments. Therefore, ultrasound may prove valuable in assessment of abnormal lateral ulnar collateral ligaments.

Cited by 30 publications

References 18 publications

Sonographic Findings for the Common Extensor Tendon of the Elbow in the General Population

Sonographic Findings for the Common Extensor Tendon of the Elbow in the General Population

Ultrasound of the elbow with emphasis on detailed assessment of ligaments, tendons, and nerves

The Elbow and Forearm: Acquired Disorders

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