Abstract
The elbow is an important synovial hinge joint of the upper extremity. This joint represents a common site of musculoskeletal symptomatology, affecting all age groups. The advantages of ultrasound imaging of the elbow include easy availability, multiplanar capability and the ability to assess structures dynamically. Patient symptomatology and site of maximal tenderness can be directly correlated with imaging findings. Comparison is easily made with the contralateral side. Particular strengths include the ability to assess para-articular structures, such as regional tendons and ligaments, in addition to assessment of joint effusions, loose bodies and regional bursae. With operator experience and excellent technique, ultrasound is a valuable imaging tool for assessment of disorders of the elbow joint.
Similar content being viewed by others
References
Barberie JE, Wong AD, Cooperberg PL, Carson BW. Extended field-of-view sonography in musculoskeletal disorders. AJR Am J Roentgenol 1998; 171:751–757.
Martinoli C, Bianchi S, Giovagnorio F, Pugliese F. Ultrasound of the elbow. Skeletal Radiol 2001; 30:605–614.
Martinoli C, Bianchi S, Zamorani MP, Zunzunegui JL, Derchi LE. Ultrasound of the elbow. Eur J Ultrasound 2001; 14:21–27.
Barr LL, Babcock DS. Sonography of the normal elbow. AJR Am J Roentgenol 1991; 157:793–798.
Miles KA, Lamont AC. Ultrasonic demonstration of the elbow fat pads. Clin Radiol 1989; 40:602–604.
Hogan MJ, Rupich RC, Bruder JB, Barr LL. Age-related variability in elbow joint capsule thickness in asymptomatic children and adults. J Ultrasound Med 1994; 13:211–213.
Bianchi S, Martinoli C. Detection of loose bodies in joints. Radiol Clin North Am 1999; 37:679–690.
De Maeseneer M, Jacobson JA, Jaovisidha S, et al. Elbow effusions: distribution of joint fluid with flexion and extension and imaging implications. Invest Radiol 1998; 33:117–125.
Koski JM. Ultrasonography of the elbow joint. Rheumatol Int 1990; 10:91–94.
Markowitz RI, Davidson RS, Harty MP, Bellah RD, Hubbard AM, Rosenberg HK. Sonography of the elbow in infants and children. AJR Am J Roentgenol 1992; 159:829–833.
Loyer EM, Dubrow RA, David CL, Coan JD, Eftekhari F. Imaging of superficial soft-tissue infections: sonographic findings in cases of cellulitis and abscess. AJR Am J Roentgenol 1996; 166:149–152.
Fessell DP, Jacobson JA, Craig J, et al. Using sonography to reveal and aspirate joint effusions. AJR Am J Roentgenol 2000; 174:1353–1362.
Lim-Dunham JE, Ben-Ami TE, Yousefzadeh DK. Septic arthritis of the elbow in children: the role of sonography. Pediatr Radiol 1995; 25:556–559.
Bureau NJ, Chhem RK, Cardinal E. Musculoskeletal infections: US manifestations. Radiographics 1999; 19:1585–1592.
van Holsbeeck MT, Introcaso JH. Musculoskeletal ultrasound, 2nd edn. St Louis: Mosby-Year Book, 2001.
Chhem RK, Cardinal E, eds. Guidelines and gamuts in musculoskeletal ultrasound. New York: Wiley, 1999.
Breidahl WH, Newman JS, Taljanovic MS, Adler RJ. Power Doppler sonography in the assessment of musculoskeletal fluid collections. AJR Am J Roentgenol 1996; 166:1443–1446.
Newman JS, Adler RS, Bude RO, Rubin JM. Detection of soft-tissue hyperemia: value of power Doppler sonography. AJR Am J Roentgenol 1994; 163:385–389.
Barr LL. Elbow. Clin Diagn Ultrasound 1995; 30:135–149.
Miller TT, Adler RS. Sonography of tears of the distal biceps tendon. AJR Am J Roentgenol 2000; 175:1081–1086.
Potter HG. Imaging of posttraumatic and soft tissue dysfunction of the elbow. Clin Orthop 2000; 370:9-18.
Lozano V, Alonso P. Sonographic detection of the distal biceps tendon rupture. J Ultrasound Med 1995; 14:389–391.
Connell D, Burke F, Coombs P, et al. Sonographic examination of lateral epicondylitis. AJR Am J Roentgenol 2001; 176:777–782.
Lin J, Jacobson JA, Fessell DP, Weadock WJ, Hayes CW. An illustrated tutorial of musculoskeletal sonography. 2. Upper extremity. AJR Am J Roentgenol 2000; 175:1071–1079.
Agur AMR, Grant JC, Lee MJ. Grant’s atlas of anatomy. Baltimore: Lippincott, Williams & Wilkins, 1999.
Daniels DL, Mallisee TA, Erickson SJ, Boynton MD, Carrera GF. The elbow joint: osseous and ligamentous structures. Radiographics 1998; 18:229–236.
Morrey BF. Anatomy of the elbow joint. In: Morrey BF, ed. The elbow and its disorders, 2nd edn. Philadelphia: Saunders, 1993:16–52.
Ward SI, Teefey SA, Paletta GA Jr, et al. Sonography of the medial collateral ligament of the elbow: a study of cadavers and healthy adult male volunteers. AJR Am J Roentgenol 2003; 180:389–394.
Gaary EA, Potter HG, Altchek DW. Medial elbow pain in the throwing athlete: MR imaging evaluation. AJR Am J Roentgenol 1997; 168:795–800.
Nazarian LN, McShane JM, Ciccotte MG, O’Kane PL, Harwood MI. Dynamic US of the anterior band of the ulnar collateral ligament of the elbow in asymptomatic major league baseball pitchers. Radiology 2003; 227: 149–154.
De Smet AA, Winter TC, Best TM, Bernhardt DT. Dynamic sonography with valgus stress to assess elbow ulnar collateral ligament injury in baseball players. Skeletal Radiol 2002; 31:671–676.
Barr LL, Kirks DR. Ultrasonography of acute epitrochlear lymphadenitis. Pediatr Radiol 1993; 23:72–73.
Sevier TL, Wilson JK. Treating lateral epicondylitis. Sports Med 1999; 28:375–380.
Miller TT, Shapiro MA, Schultz E, Kalish PE. Comparison of sonography and MRI for diagnosing epicondylitis. J Clin Ultrasound 2002; 30:193–202.
Jacobson JA, Jebson PJL, Jeffers AW, Fessell DP, Hayes CW. Ulnar nerve dislocation and snapping triceps syndrome: diagnosis with dynamic sonography—report of three cases. Radiology 2001; 220:601–605.
Kaempffe FA, Lerner RM. Ultrasound diagnosis of triceps tendon rupture. Clin Orthop 1996; 332:138–142.
Fornage BD. Peripheral nerves of the extremities: imaging with US. Radiology 1988; 167:179–182.
Okamoto M, Abe M, Shirai H, Ueda N. Morphology and dynamics of the ulnar nerve in the cubital tunnel: observation by ultrasonography. J Hand Surg [Br] 2000; 25:85–89.
Loewy J. Sonoanatomy of the median, ulnar and radial nerves. Can Assoc Radiol J 2002; 53:33–38.
Silvestri E, Marinoli C, Derchi LE, Bertolotto M, Chiaramondia M, Rosenberg I. Echotexture of peripheral nerves: correlation between US and histologic findings and criteria to differentiate tendons. Radiology 1995; 197:291–296.
Okamoto M, Abe M, Shirai H, Ueda N. Diagnostic ultrasonography of the ulnar nerve in cubital tunnel syndrome. J Hand Surg [Br] 2000; 25:499–502.
Steiner E, Steinbach LS, Schnarkowski P, Tirman PFJ, Benant HK. Ganglia and cysts around joints. Radiol Clin North Am 1996; 34:395–425.
Frankel DA, Bargiela A, Bouffard JA, Craig JG, Shirazi KK, van Holsbeeck MT. Synovial joints: evaluation of intraarticular bodies with US. Radiology 1998; 206:41–44.
Miller JH, Beggs, I. Detection of intraarticular bodies of the elbow with saline arthrosonography. Clin Radiol 2000; 56:231–234.
Davidson RS, Markowitz RI, Dormans J, Drummond DS. Ultrasonographic evaluation of the elbow in infants and young children after suspected trauma. J Bone Joint Surg 1994; 76:1804–1813.
Lazar RD, Waters PM, Jaramillo D. The use of ultrasonography in the diagnosis of occult fracture of the radial neck. J Bone Joint Surg 1998; 9:1361–1364.
May DA, Disler DG, Jones EA, Pearce DA. Using sonography to diagnose an unossified medial epicondyle avulsion in a child. AJR Am J Roentgenol 2000; 174:1115–1117.
Takahara M, Ogino T, Tsuchida H, Takagi M, Kashiwa H, Nambu T. Sonographic assessment of osteochondritis dissecans of the humeral capitellum. AJR Am J Roentgenol 2000; 174:411–415.
Takahara M, Shundo M, Kondo M, Suzuki K, Nambu T, Ogino T. Early detection of osteochondritis dissecans of the capitellum in young baseball players. J Bone Joint Surg Am 1998; 80:892–897.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Finlay, K., Ferri, M. & Friedman, L. Ultrasound of the elbow. Skeletal Radiol 33, 63–79 (2004). https://doi.org/10.1007/s00256-003-0680-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00256-003-0680-7