Ultrasonography of the annular ligament partial tear and recurrent ?pulled elbow?

Kim, Moon C.; Eckhardt, Boris P.; Craig, Clifford L.; Kuhns, Lawrence R.

doi:10.1007/s00247-004-1284-7

Cited by 23 publications

(13 citation statements)

References 6 publications

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“…However, more recent anatomical and biomechanical studies have challenged that concept and the entire LCL is now considered by many to be equally important for lateral elbow stability [2, 18, 23–28]. Although the anatomy of the LCL has been well described, only a few studies have focused on its ultrasound aspects [16, 29–32]. The ultrasound appearance of LUCL and the annular ligament has been described in the literature, but limited information is available on the relations between the components of the LCL and the differentiation of these components from the nearby tendons [16, 29, 30].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound assessment of the lateral collateral ligamentous complex of the elbow: imaging aspects in cadavers and normal volunteers

Teixeira¹,

Omoumi

Trudell

et al. 2011

Eur Radiol

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ObjectiveThe Lateral Collateral Ligamentous complex (LCL) is an important stabiliser of the elbow. It has a Y-shaped structure with three components. In this study, we sought to describe the ultrasound aspect of the individual components of this ligamentous complex and to evaluate the performance of ultrasound in both cadavers and in normal subjects.MethodsTen cadaveric elbow specimens underwent high-frequency ultrasound. Two specimens were sliced and two were dissected for anatomical correlation. Ten elbows of normal subjects were also evaluated by ultrasound. The findings were compared.ResultsThe three components of the LCL could be visualised in all specimens and normal subjects with the exception of the proximal portion of one specimen. In 80% of the specimens and 100% of the healthy volunteers the proximal portion of the LCL could be separated from the extensor tendons.ConclusionHigh-resolution ultrasound can assess all components of the LCL of the elbow and can distinguish them from surrounding structures.

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Section: Discussionmentioning

confidence: 99%

Ultrasound assessment of the lateral collateral ligamentous complex of the elbow: imaging aspects in cadavers and normal volunteers

Teixeira¹,

Omoumi

Trudell

et al. 2011

Eur Radiol

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“…In case 4, an infant not using her right arm, a normal posterior fat pad would make the possibility of occult elbow fracture less likely, thus encouraging us to proceed with a nursemaid's elbow reduction maneuver. Sonographic findings for nursemaid's elbow have been reported [17]; however, in our experience, we have found these findings to be more technically challenging to acquire than scanning for the posterior fat pad sign.…”

Section: Discussionmentioning

confidence: 49%

Rapid screening for the posterior fat pad sign in suspected pediatric elbow fractures using point-of-care ultrasound: a “FAST exam” for the traumatized elbow

Tsung

Blaivas

2010

Crit Ultrasound J

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Purpose Children with elbow injuries frequently present to the emergency department for evaluation. Fractures of the elbow are sometimes not visualized on plain radiographs and the only sign of an occult fracture is an elevated posterior fat pad that normally sits within the olecranon fossa. The elevated posterior fat pad sign is highly sensitive and its absence likely rules out fractures of the elbow and can be readily visualized by ultrasound. Lipohemarthrosis within an elevated fat pad can also be visualized by ultrasound, but not by X-ray. This finding with an elevated posterior fat pat adds additional specificity to rule in elbow fractures. Methods We report the use of point-of-care ultrasound to rapidly screen for the presence of the posterior fat pad sign and lipohemarthrosis in a series of children presenting with elbow injuries to the emergency department. Results Point-of-care ultrasound identified elevated and normal posterior fat pads that correlated with X-ray. Lipohemarthrosis within an elevated fat pad was also detectable by ultrasonography.Conclusions Knowledge of whether a posterior fat pad is elevated or not and noting the presence of lipohemarthrosis by using point-of-care ultrasound may be helpful to expedite diagnosis and treatment of these patients, especially in settings with no access to plain radiography.

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“…The main purpose of radiography is to exclude joint effusion, fracture, or dislocation. The displaced annular ligament can be identifi ed at US [ 43 ] or MRI (Fig. 8.28 ).…”

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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Ultrasonography of the annular ligament partial tear and recurrent ?pulled elbow?

Cited by 23 publications

References 6 publications

Ultrasound assessment of the lateral collateral ligamentous complex of the elbow: imaging aspects in cadavers and normal volunteers

Ultrasound assessment of the lateral collateral ligamentous complex of the elbow: imaging aspects in cadavers and normal volunteers

Rapid screening for the posterior fat pad sign in suspected pediatric elbow fractures using point-of-care ultrasound: a “FAST exam” for the traumatized elbow

The Elbow and Forearm: Acquired Disorders

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