Synovial plica of the elbow and its clinical relevance

Lubiatowski, Przemysław; Wałecka, Joanna; Dzianach, Marcin; Stefaniak, Jakub; Romanowski, Leszek

doi:10.1302/2058-5241.5.200027

Cited by 13 publications

(16 citation statements)

References 33 publications

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“…The highest density of elastic fibers in the AJC implicates its required elasticity in daily life activities such as flexion, extension and pronosupination to position the hand in space (Morrey et al, 1981; Sardelli et al, 2011). Moreover, it prevents entrapment of capsule tissue (Kielty et al, 2002), such as in painful plica syndrome (Lubiatowski et al, 2020). The low amount of elastic fibers in the AUCL reflects its primary stabilizing role in valgus stress.…”

Section: Discussionmentioning

confidence: 99%

Comparative histomorphological analysis of elbow ligaments and capsule

et al. 2022

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This study aimed to compare the histomorphology of the elbow capsule and its ligaments to gain a better understanding of the clinically relevant biomechanical stabilization. Eleven human elbows were dissected including the joint capsule with its anterior (AJC) and posterior (PJC) parts, the annular ligament (AL), the radial collateral ligament (RCL) and the ulnar collateral ligament with its anterior (AUCL), posterior (PUCL) and transverse (TUCL) parts. Hematoxylin–Eosin and Elastica van Gieson as conventional histology stainings were applied to determine collagenous and elastic fiber arrangements in transmission and polarization light microscopy. The radial collateral ligament and the anterior part of the ulnar collateral ligament showed significantly more densely packed parallel fiber arrangement than the anterior joint capsule, the posterior joint capsule, and the posterior part of the ulnar collateral ligament (p < 0.02, respectively). The PUCL had significantly more mixed tight and loose parallel arrangements than the PJC, the annular ligament, the RCL, the AUCL and the transverse part of the ulnar collateral ligamentp < 0.02, respectively), while the PJC showed significantly more interlaced mixed tight and loose fiber arrangement than the AL, the RCL and the AUCL (p < 0.003, respectively). The AJC had a significantly higher amount of elastic fibers as compared to the AL, the RCL, the AUCL and the TUCL in fascicular regions (p < 0.04, respectively), while the AUCL had significantly lesser elastic fibers than the AJC and the PJC (p < 0.004, respectively). The densely packed parallel fiber arrangement and few elastic fibers of the AUCL, RCL, and AL indicate a strong biomechanically stabilizing function. The fiber arrangement of the PUCL and the TUCL with few elastic fibers support the medial elbow stabilization. Crimping and elastic fibers provide the viscoelasticity of the joint capsule.

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Section: Discussionmentioning

confidence: 99%

Comparative histomorphological analysis of elbow ligaments and capsule

et al. 2022

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“…Various intra-articular soft-tissue abnormalities of the radiocapitellar joint have been reported in clinical and cadaveric studies [ 4 , 5 , 6 ]. These abnormalities include synovial plicas, folds, masses, cords, bands, and fringes; menisci; meniscoids; and meniscocapsular complexes.…”

Section: Discussionmentioning

confidence: 99%

“…Unlike anterior synovial folds, which have been arthroscopically classified, posterior synovial folds or other abnormalities have not been classified. Most posterior intra-articular abnormalities are interposed in the radiocapitellar joint, leading to catching or locking of the elbow [ 4 , 5 , 6 ]. To the best of our knowledge, tendon-like intra-articular abnormalities similar to that in this case have not been reported in clinical or cadaveric studies.…”

Section: Discussionmentioning

confidence: 99%

A Rare Intra-articular Abnormality in the Posterior Radiocapitellar Joint: A Case Report

Uchino¹,

Suzuki²,

Kimura³

et al. 2022

JOCR

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Introduction: Posterior radiocapitellar synovial plica excision is sometimes performed for lateral epicondylitis after debridement of the extensor carpi radialis brevis (ECRB) tendon. We describe a rare intra-articular abnormality of the posterior radiocapitellar joint diagnosed on posterior arthroscopic observation. Case Report: A 48-year-old man presented with posterolateral pain and discomfort in his left elbow. A diagnosis of lateral epicondylitis was made, and arthroscopic debridement of the ECRB tendon was performed. Posterior arthroscopic examination revealed a tendon-like abnormality running longitudinally along the articular surface of the capitulum of the humerus. The abnormality was resected using a shaver, and symptoms improved postoperatively. Conclusion: In patients with posterolateral pain and discomfort or catching of the elbow, posterior arthroscopic confirmation of the intra-articular structure is recommended after debridement of the ECRB tendon.

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“…Hence, these data indicate that either resection or reconstruction of the annular ligament can be performed in patients affected by this type of snapping with a substantial and clinically relevant amelioration of symptoms (35). Painful synovial plicae in the postero-lateral corner of the radiohumeral joint may generate snapping (59). Plicae are meniscus-like remnants of fetal development of the elbow joint (32,60).…”

Section: Intra-articular (Lateral) Snappingmentioning

confidence: 91%

“…Plicae are meniscus-like remnants of fetal development of the elbow joint (32,60). They are found in 86% -100% of cases, but symptomatic plicae are much less common representing only 7.2%-8.7% of all elbow arthroscopies (59). Plicae undergo significant modifications from homogenous structures intermingled with the annular ligament in fetuses to a more heterogenous appearance in adults (61).…”

Section: Intra-articular (Lateral) Snappingmentioning

confidence: 99%

Snapping of the Upper Limb: a Clinical Overview

Moscagiuri¹,

Frizziero²,

Bigliardi³

et al. 2022

Muscle Ligaments and Tendons J

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Snapping results from an abrupt displacement of an anatomic or pathologic structure during the movement of a closely related joint. Snaps are audible, palpable, and often, visible. Snapping phenomena are common within the general population and, in most cases, are associated with mild symptoms. However, especially in athletes, snapping could determine pain and functional impairment that may severely affect their sport activities. We focus on three major types of snapping occurring at specific joints of the upper limbs: the shoulder, the elbow, and the wrist. Here, we provide a comprehensive overview of major advances in the aetiology, pathophysiology, diagnostic imaging, and treatments of these specific snapping phenomena.

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Synovial plica of the elbow and its clinical relevance

Cited by 13 publications

References 33 publications

Comparative histomorphological analysis of elbow ligaments and capsule

Comparative histomorphological analysis of elbow ligaments and capsule

A Rare Intra-articular Abnormality in the Posterior Radiocapitellar Joint: A Case Report

Snapping of the Upper Limb: a Clinical Overview

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