Elbow

Question 1

traumatic injuries

Answer 1

• FOOSH
• Supracondylar fractures
• Radial distal head fractures
• Olecranon fracture
• Elbow dislocations

Question 2

Athletic injuries

Answer 2

• osteochondritis dissecans
• Epicondylitis
• UCL tears
• Snapping triceps

Question 3

Radiograph views of the elbow

Answer 3

• AP
• Lateral
• Oblique
• ER

Question 4

AP view

Answer 4

• pts arm fullt EXT in anatomic position
• Carrying angle can be assessed
• Humeroradial and humeroulnar spaces

Question 5

Lateral view

Answer 5

• elbow FLX to 90 deg and thumb towards ceiling used to assess the humeroulnar jt.
• coronoid and olecranon process

Question 6

Oblique ER

Answer 6

• forearm is fully PRONATED
• radial head, neck, and tuberosity
• can see biceps tuberosity

Question 7

MRI

Answer 7

• **soft tissue, stress fracture/bone marrow abnormalities
• collateral, radial, or annula lig tears
• epicondylitis
• distal biceps or triceps tendon tears
• osteochondral lesions
• intra-articular loose bodies
• olecranon and bicipitoradial bursitis
• marrow abnormalities
• ulnar nerve compression
• symptomatic plicae
• neoplasms or infections
• abnormalities of prox forearm
• inteross mem

Question 8

MRI axial

Answer 8

• identify- biceps, triceps tendon, annular lig at radial head, unlar nerve deep to the triceps in cubital tunnel

Question 9

MRI sagittal

Answer 9

• biceps and triceps tendon
• ant and post muscle groups
• radial head assessment
• humeroradial and humeroulnar jts

Question 10

MRI coronal

Answer 10

• identify-
  
  • med and lat collateral lig
  • med and lat epicondyles
  • common flx and ext tendons
  • bicipitoradial bursa between biceps tendon and radial tuberosity
  • prox radioulnar jt

Question 11

MR arthrogram

Answer 11

• injected into jt capsule
• MCL part of jt.
• All connected.
• Can leak out, not just isolated with image

Question 12

Anterior compartment

Answer 12

• distal biceps rupture
  
  • 90% of biceps tendon ruptures occur at the long head
• complete tear
  
  • gap between the two retracted tendon ends
• partial tear
  
  • abnormally high signal within tendon on T2 weighted image

Question 13

Posterior compartment

Answer 13

• triceps tendon ruptures
  
  • less common
• snapping triceps tendon
  
  • abnormal slipping of the medial head over the medial condyle
• olecranon bursitis
  
  • high signal focal collection of fluid over the olec process (gout, tri tears, or rep pressure on bone)
• gout
  
  • uric acid. serum analysis done.
• student elbow
  
  • prolonged press on elbow

Question 14

Medial compartment

Answer 14

• medial epicondylitis
• ulnar (medial) collat lig tears

Question 15

Lateral compartment

Answer 15

• Lateral epicondylitis
• Radial (lateral) collat lig tear
• pain with EXT
• Test instability (varus)

Question 16

CT scan indications

Answer 16

• severe trauma
• alignment and displacement of fracture fragments
• loose bodies in the elbow jt
• osteochondral lesions
• if MRI is contraindicated
• any condition if MRI contraindicated CT 3D can be used to help with surgical planning

Question 17

MS US indications

Answer 17

• tears, tendinosis, and/or calcification tears of collar lig (dynamic valgus or varus stress)
• olecranon and bicipitoradial bursitis
• osteochondral deficits
• nerve entrapment
• ulnar nerve and medial head of triceps dislocation
• **operator dependent

Question 18

Fracture-dislocation (monteggia’s)

Answer 18

• imaging-radiographs for diagnosis.

Question 19

Elbow disocation

Answer 19

• AP and lateral radiographs are diagnostic

Question 20

Epicondylitis

Answer 20

• radiographs rule out associated disorders, MRi and US for specific tissue inflammation and tendon degeneration