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Elbow

  • Matthew Egan
  • David Spinner
Chapter

Abstract

The elbow has multiple bony and soft tissue structures that can be imaged superficially to aid in diagnosis of common pathology. For common overuse injuries such as “golf elbow” and “tennis elbow,” ultrasound can evaluate the associated flexor and extensor tendons to identify acute conditions, compared with chronic symptoms of overuse. According to the American College of Radiology, ultrasound may be adequate as an initial evaluation for epicondylitis, allowing MRI to be used if ultrasound findings are normal [1, 2]. This evaluation can potentially decrease costs. For similar functional injuries, ultrasound may be performed to evaluate for ligamentous damage to the ulnar and radial collateral ligaments. According to the Appropriateness Criteria of the American College of Radiology, both ultrasound and MRI may be used to detect soft tissue abnormalities [1]. Confirming these diagnoses by point-of-care ultrasound ensures that patients move forward with the right plan of care and do not undertreat an undiagnosed pathology. In the setting of the nontraumatic, swollen elbow, point-of-care ultrasound can evaluate for joint effusion and bursitis, potentially helping to obviate the need for aspiration. Additionally, in patients who have muscular pain after lifting or heavy exertion, point-of-care ultrasound may be performed to evaluate for tears and rupture of the triceps and biceps brachii tendons, as well as to evaluate for muscle tears. For distal neuropathic pain or for invasive procedures, ultrasound also may be used to guide regional anesthesia in the ulnar, median, or radial nerves, all of which can be seen on point-of-care elbow ultrasound, as discussed further in Chap.  8, Peripheral Nerves. Figures 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7 and 3.8 illustrate the various probe positions and the resulting views in the elbow area.

Keywords

Elbow Olecranon Joint Humerus Triceps Epicondyle 

References

  1. 1.
    American College of Radiology. ACR appropriateness criteria®. https://acsearch.acr.org/docs/69423/Narrative/. Accessed 23 Oct 2017.
  2. 2.
    Miller TT, Shapiro MA, Schultz E, Kalish PE. Comparison of sonography and MRI for diagnosing epicondylitis. J Clin Ultrasound. 2002;30:193–202.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Emergency MedicineIcahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Department of Rehabilitation MedicineMount Sinai HospitalNew YorkUSA

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