Elbow Flashcards
S2Q3
ELBOW
what task, joints (3)
- prehensile task
- PRUJ, HUJ, HRJ
ELBOW: Radio
which views (2.1)
AP - position (2), sees (3) + superimposed (1.0), ray where
ant, lateral > oblique
AP view
- position: ER EXT (resting)
- sees: olecranon in fossa, HUJ, HRJ
- superimposed: radius
- ray: perpendicular to elbow joint
ELBOW: Radio
lateral - position (1), sees (4), superimposed (2.1), shape of (2)
- position: FLEX
- sees: olecranon in fossa, proximal humerus, proximal RU
- superimposed: coronoid, epicondyles
- clear: radius
- fat pad of coronoid & radius = triangle
ELBOW: Radio
oblique IR - position (3) + degree, superimposed (1.0), best seen
- position: IR 90, PRO, EXT
- superimposed: proximal RU
- best: coronoid
ELBOW: Radio
oblique ER - position (3) + degree, best seen, (2) seen in what, see (2)
- position: ER 45, SUP, EXT
- best: radius
- capitulum & lat epi seen in profile
- see: HRJ, HUJ
ELBOW: Radio
AP forearm - position (1), see (5)
lateral forearm - position (1), superimposed (2.0) + characteristics to check (2)
AP forearm
- position: EXT
- see: elbow, RU shafts, olecranon in fossa, wrist
Lateral forearm
- position: FLEX
- see: elbow, entire RU, olecranon in fossa, wrist
- superimposed: RU shafts
- check RU contour & bowing
ELBOW: Imaging
check (4)
CT (2), MRI (3), US (3)
positions of body (2) + arms (2), alternative position (3)
— check: HICO
- HO, intraarticular loose bodies, Ca deposits, osteophytes
CT - loose bodies, lesions
MRI - tendon, capsule, synovium
US - tendon tear, bursitis, epicondylitis
- supine/prone, mighty mouse (one arm up) or superman (both)
- alternative: FLEX elbow, ABD, SUP
ELBOW: Imaging - CT
from to (2G)
alignment - axial (2) sagittal (1G), extra (1G)
bone - cancellous where, see (6)
cartilage space - (2), condition + where (2)
soft tissue - ant pos lat med (2 each), conditions (3)
— soft tissue condition: BAE
- metaphysis of distal humerus to metaphysis of proximal radius
- med to lat epicondyle
alignment
- axial: HRUJ
- sagittal: trochlea x ulnar trochlear notch
- radial head x capitulum
bone
- cancellous at medullary cavity
- see: cyst, sclerosis, hypertrophy, disease, infection, trabeculae
cartilage space
- free fragments, HRUJ
- osteochondral lesions at radial head & capitulum
soft tissue
- ant: biceps, brachialis
- pos: triceps, anconeus
- lat: origin of EXT SUP
- med: origin of FLEX PRO
- bursitis, atrophy, effusion
ELBOW: Imaging - MRI
MRA - see (4), contrast see (1)
bone - see (3)
- see: cartilage, torn collateral ligament, unstable lesion, osteochondral fx
- with contrast: better joint
bone
* see: stress fx, bruise, osteochondral fx
ELBOW: Imaging - MRI (Soft Tissue)
which tendon common tear + finding in imaging
condition - finding in imaging, pathology, associated (3) + define 3rd
condition 2 - etiology (1=1)
best views (2)
coronal - conditions (2) + findings in imaging (2) + which is more common
- biceps tendon: common tear, high signal
bicipitoradial bursitis
* high signal
* inflammation
* associated: gout, triceps tear, student’s elbow (repetitive pressure)
snapping triceps
* triceps glide over medial epi = dislocate ulnar nerve
best views: axial, coronal
coronal view
* MCL & LCL = thickened lig, high signal, MCL more common
ELBOW: Conditions - Trauma
MOI (3)
radio
* sign (1=1)
* other sx - describe (2) + what view, radial fx =(3)
MOI
* FOOSH, overuse/microtrauma
radio
* (+) fat pad sign: effusion = displace pad
* abnormal supinator line: thin lucent line seen in lat view; radial fx = elevate widen blur
ELBOW: Conditions - Distal H. Fx
supracondylar - age, associated (3)
condylar - age, med vs. lat, d/t
epicondylar - med vs. lat, dt (3)
intercondylar - age, d/t, describe (2)
transcondylar - age + d/t, describe (1)
articular - describe (1) + where (2)
which rare
supracondylar
* kids
* gunstock, volkmann’s ischemia, PNI
condylar
* kids
* lat > med d/t varus
epicondylar
* med > lat
* d/t avulsion, dislocation, blow
intercondylar
* adults
* d/t force
* condyle in humerus, torn into “T/Y”
transcondylar
* elder d/t osteoporosis
* condyle in olecranon fossa
articular
* rare
* condyle in trochlea or capitulum
ELBOW: Conditions - Distal H. Fx
tx - position + duration, non-op if (2), op if (3)
- 90, 6w
- non-op if: minimal displacement, osteopenia
- op if: open fx, displacement, vascular injury
ELBOW: Conditions - Proximal R. Fx
classification - 1st-3rd describe + tx (1.2.1), 4th is d/t + tx
tx - non-op vs. op
complications (3) + d/t of 1st
mason
* I: nondisplaced = immob
* II: displaced = conservative or excision
* III: comminuted = resection
* IV: if d/t dislocation = tx p reduction
tx
* non-op: sling
* op: excision proximal to annular ligament
complications
* wrist pain d/t ant interosseous ligament
* TFCC, arthritis
ELBOW: Conditions - Proximal U. Fx
if disrupt x then what (2G)
views (2)
tx - position + duration, op (2)
- if disrupt trochlear notch = bye FLEX EXT, medlat stability
- views: AP, lat
tx
* flex 2w
* op: open reduction, internal fixation
