The Determination of Interobserver and Intraobserver Reliability of a Magnetic Resonance Imaging Based Classification System for Ulnar Collateral Ligament Injury

Background The elbow is one of the most commonly dislocated joints, and dislocation is usually accompanied with an assortment of soft tissue injuries. The purpose of this study was to retrospectively analyze and describe the patterns of ligamentous, tendinous, and muscular injuries in patients with an acute elbow dislocation and subsequent magnetic resonance image (MRI) evaluation. Methods From 2008 to 2020, 235 patients clinically diagnosed with an elbow dislocation were seen in the department, of which only 19 underwent an MRI of the affected elbow. Twelve patients met inclusion criteria, and MRIs were evaluated by both a radiologist and an upper extremity orthopedic surgeon. Magnetic resonance images were assessed for injury to the ulnar collateral ligament (UCL); radial collateral ligament (RCL); lateral ulnar collateral ligament (LUCL); common flexor and extensor tendons; biceps, brachialis, and triceps tendons; fracture; and joint effusion. Results Magnetic resonance imaging findings included the following: UCL was injured in 11 of 12 patients; RCL was injured in 9 of 12 patients; LUCL was injured in 9 of 12 patients; common flexor tendon was injured in 11 of 12 patients; and common extensor tendon was injured in 9 of 12 elbows. The biceps, brachialis, and triceps tendons showed injury in 1 of 12, 2 of 12, and 2 of 12 elbows, respectively. Four elbows had at least 1 fracture present, whereas 8 demonstrated an effusion. Conclusions In this series, injuries to the UCL and common flexor tendon were most common. Although ligamentous injuries are exceedingly common in elbow dislocations, large studies of MRI findings prove difficult due to MRI costs.

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Investigation of ligament, bone, synovial and plica pathologies accompanied by common extensor tendon in patients with lateral overuse syndrome of the elbow using magnetic resonance imaging

Acta Radiologica ◽

10.1177/0284185121990797 ◽

2021 ◽

pp. 028418512199079

Author(s):

Sinem Aydoğmuş ◽

Berna Dirim Mete ◽

Hüseyin Aydoğmuş ◽

Muhsin Engin Uluç ◽

Özgür Tosun ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Extensor Tendon ◽

Joint Effusion ◽

Ligament Injury ◽

Resonance Imaging ◽

Collateral Ligament ◽

Overuse Syndrome ◽

Signal Change ◽

The Common

Background Tendinosis in the common extensor tendon and accompanying ligament, bone, and plica abnormalities can be observed on magnetic resonance imaging (MRI). Purpose To determine whether there is a difference between accompanying abnormalities according to the degree of common extensor tendon injury Material and Methods Patients who underwent 1.5-T MRI tests with a prediagnosis of lateral overuse syndrome were retrospectively reviewed, and 56 patients who had an injury in the common extensor tendon (CET) were included. The degree of tendon and ligament injury, muscle signal change, bone marrow signal change, presence of joint effusion, and morphological features in the presence of plica were evaluated via MRI examinations of the elbow. Results Overall, 32, 16, and eight patients had mild, moderate, and severe CET damage, respectively. As the severity of CET damage increased, the presence of joint effusion, and the presence and degree of damage to the lateral ulnar collateral ligament (LUCL) and radial collateral ligament (RCL) increased. The radiohumeral (RH) plica area was significantly larger in the group with mild CET damage. There was no statistically significant correlation between the severity of CET damage and the end of RH plica with a blind-end, coverage of one-third or more of the radius, its signal, thickness, and presence of olecranon fold. Conclusion As the severity of CET injury increases, damage to the LUCL, RCL, and the presence of effusion in the joint increases. RH plica should be evaluated in terms of concomitant pathology in patients with mild CET injuries on MRI.

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