The Elbow

Question 1

Why is it difficult to treat trauma at the elbow?

Answer 1

3 separate articulations at one joint make it difficult to treat

Question 2

What is the most common MOI at the elbow?

Answer 2

Fall on an outstretched hand (FOOSH)

Question 3

What 4 pathologies are visualized by x-ray at the elbow?

Answer 3

1. Fractures
2. Dislocations
3. Calcific tendonitis
4. Arthritis

Question 4

What do CT scans visualize at the elbow?

Answer 4

Complex fractures, especially in characterizing fracture/dislocation of the radius/ulna and distal humerus

Question 5

What 3 conditions does MRI visualize at the elbow?

Answer 5

1. Soft tissue abnormalities
2. Chondral and osteochondral lesions
3. Radiographically occult bone abnormalities

Question 6

What is musculoskeletal US typically used for at the elbow?

Answer 6

Dynamic assessment demonstrating nerve or muscle subluxation

Question 7

What 3 projections/views make up the routine radiological examination at the elbow?

Answer 7

1. AP
2. Lateral
3. Oblique (external rotation)

Question 8

What are the ABCDs of the elbow?

Answer 8

1. Alignment
2. Bone Density
3. Cartilage
4. eDema
5. Soft Tissue

Question 9

What are the 6 secondary centers of ossification at the elbow? (CRITOE)

Answer 9

Capitulum  
Radial Head  
Internal (medial) epicondyle
Trochlea  
Olecranon  
External (lateral) epicondyle

Question 10

What 2 abnormalities are HIGHLY associated with fractures at the elbow?

Answer 10

1. Positive fat pad sign

2. Abnormal supinator line

Question 11

What are the ABCs at the elbow?

Answer 11

1. Alignment
2. Bone Density
3. Cartilage
4. Soft tissue

Question 12

What is considered the first line examination at the elbow?

Answer 12

Musculoskeletal Ultrasound (MSUS) performed in conjunction with conventional radiography

Question 13

What 4 clinical symptoms warrant MSUS examinations at the elbow?

Answer 13

1. Pain
2. Swelling
3. Joint instability
4. Presence of mass.