Learning objectives
1.
To provide a comprehensive review of the normal anatomy and the biomechanics aspects of the medial and lateral collateral ligaments.
2.
To highlight important technical aspects that optimise visualitation of anatomic structures.
3.
To explain the spectrum of MRI findings of traumatic and overuse injuries.
Background
1.
Technical aspects.
· Elbow MRI protocols recommended for each diagnostic suspicion.
· Normal anatomy and biomechanical aspects of the joint capsule
and collateral ligaments.
· Medial collateral ligament complex.
· Lateral collateral ligament complex.
2.
Pathophyfisiology.
· Valgus and varus instability.
· Posterolateral rotatory instability and elbow dislocation.
3.
Review of imaging findings.
4.
Sample cases and mimics.
Findings and procedure details
A) PULSE SEQUENCES
1.
Patient supine with the affected arm by the side of the body,
elbow extension,
and forearm in supination.
2.
Surface coils.
3.
Matrix: 256 x 192 or 256 x 256.
4.
Fov: 12- 14 cm.
5.
Axial: slice thickness 4 mm Fig. 1 .
6.
Coronal and sagittal: slice thickness 3 mm Fig. 1 .
7.
A 20 degrees posterior oblique coronal plane in relation to the
humeral shaft with the elbow extended or a coronal plane aligned
with the humeral...
Conclusion
1.
Anatomical and biomechanical knowledge of the support structures that provide stability to the medial and lateral elbow is essential to correcly interpret the pathological findings.
2.
The anterior band of the collateral medial ligament complex is the main stabilizer against valgus and internal rotation stress.
3.
The collateral lateral ligement complex resist excesive varus and external rotacional stress.
The LUCL is the most important in terms of stability.
4.
Conventional MRI and MR artrography are the imaging modality of choice.
5.
The most common...
Personal information
Dr.
José Acosta Batlle.
Universitary Ramón y Cajal Hospital.
University of Alcala Henares.
Madrid.
Spain.
[email protected]
References
1.
Stein JM,
Cook TS,
Simonson S et al (2011).
Normal and variant anatomy of the elbow on magnetic resonance imaging.
Magn Reson Imaging Clin N Am 19(3):609-619.
2.
Seki A,
Olsen BS,
Jensen SL et al (2002).
Functional anatomy of the lateral collateral ligament complex of the elbow: configuration of Y and its role.
J Shoulder Elb Surg 11(1):53-59.
3.
Beckett KS,
Mc Connell P,
Lagopoulos M et al (2000).
Variations in the normal anatomy of the collateralligaments of the human elbow joint.
J...
