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Radiologic Imaging of Elbow and Forearm Injuries

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Nuclear Medicine and Radiologic Imaging in Sports Injuries

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Abstract

The elbow joint has a complex “trochoginglymoid “architecture which allows for the wide range of motion, including hinged (elbow flexion and extension) and rotational (forearm supination and pronation) motion.

Stability is dependent on the congruity of this articulation with major support of the medial and lateral ligament complex but with only a minor contribution of the muscles.

Acute varus, valgus, anterior, and posterolateral overload may result in a variety of fractures and lead to recurrent instability and overuse injury.

Although lower limb injuries are the most common and comprise 74 % of all sports injuries (Alonso et al. 2012), upper limb injuries are an important cause of reduced performance and loss of playing time for athletes. Upper limb injuries are most common in throwing sports but frequently occur in weight-lifting sports as well.

Imaging of acute injuries in most cases involves conventional radiographs to visualise osseous anatomy and pathology but offers only limited soft tissue evaluation.

US provides high-resolution images of the muscle, tendons, and ligaments, including dynamic assessment of the joint movement and (sub)luxation of the tendons and nerves. Hypervascularisation and angiogenesis are easily assessed with Doppler ultrasound. The ultrasound examination is typically focused on the area of tenderness and discomfort.

MRI and MR arthrography are the best imaging techniques in complex pathology with involvement of bone, joint, and soft tissues.

The 2D and 3D multiplanar reconstruction capacity of CT depicts the complex osseous anatomy and pathology in fracture dislocation and fracture healing and in soft tissue calcification and ossification.

Good knowledge of the (functional) anatomy and its variants is mandatory.

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Abbreviations

AIN(S):

Anterior interosseous nerve (syndrome)

CECS:

Chronic exertional compartment syndrome

CT:

Computerised tomography

DTPA:

Diethylenetriaminepentaacetate

ECRL:

Extensor carpi radialis longus muscle

ESWT:

Extracorporeal shock wave therapy

FABS:

Flexion, abduction and supination position of the elbow

FS:

Fat suppression

LCL:

Lateral collateral ligament

LCLC:

Lateral collateral ligament complex

LUCL:

Lateral ulnar collateral ligament

MCL:

Medial collateral ligament

MR(I):

Magnetic resonance (imaging)

PIN:

Posterior interosseous nerve (distal motor branch of the radial nerve)

PLRI:

Posterolateral rotator instability

PNT:

Percutaneous needle tenotomy

PPV:

Positive predictive value

SI:

Signal intensity

SNR:

Signal to noise ratio

STIR:

Short tau inversion recovery

US:

Ultrasound

VEO:

Valgus extension overload

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Authors and Affiliations

  1. Department of Radiology, Maartenskliniek, Nijmegen, The Netherlands

    M. Obradov

  2. Department of Radiology, Antwerp University Hospital, Wilrijkstraat 10, B2650, Nijmegen, The Netherlands

    Jan L. M. A. Gielen

  3. Department of Sports Medicine, Antwerp University Hospital, Wilrijkstraat 10, B2650, Edegem, Belgium

    Jan L. M. A. Gielen

  4. Department of Medicine, Antwerp University, Wilrijkstraat 10, B2650, Edegem, Belgium

    Jan L. M. A. Gielen

Authors
  1. M. Obradov
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  2. Jan L. M. A. Gielen
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Corresponding author

Correspondence to M. Obradov .

Editor information

Editors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Andor W.J.M. Glaudemans

  2. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Rudi A.J.O. Dierckx

  3. Department of Radiology, Antwerp University Hospital, Edegem, Belgium

    Jan L.M.A. Gielen

  4. Exercise and Health, Center for Sports Medicine, University Center for Sport, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Johannes (Hans) Zwerver

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Obradov, M., Gielen, J.L.M.A. (2015). Radiologic Imaging of Elbow and Forearm Injuries. In: Glaudemans, A., Dierckx, R., Gielen, J., Zwerver, J. (eds) Nuclear Medicine and Radiologic Imaging in Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46491-5_20

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  • DOI: https://doi.org/10.1007/978-3-662-46491-5_20

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