Abstract
Background
Ultrasound is suitable for routine examinations of capitellar osteochondritis dissecans because it can visualize both the subchondral bone and the overlying articular cartilage non-invasively. The radial head interferes with the sonographically visible area of the articular surface of the humeral capitellum, although the precise extent of this is currently unknown. This study aimed to investigate the visible area of the humeral capitellum using both anterior and posterior ultrasonographic scans.
Methods
Twelve elbows were used from cadavers with a mean age of 85.6 years. After marking a 45° angle in the anterior capitellum in a caudal direction using a drill, anterior and posterior, long-axis ultrasonographic scans were performed with the cadaveric elbows bent. The elbow-flexion angle at which the 45° point was obscured by the radial head was measured and these ultrasonic measurements were then verified by macroscopic observation.
Results
The elbow-flexion angle at which the 45° point was obscured by the radial head was 24° in anterior scans and 102° in posterior scans. These ultrasonic measurements corresponded to the macroscopic measurements. The results showed that anterior, long-axis ultrasound scans could visualize the capitellum from 45° through the rest of the anterior area at 24° flexion of the elbow: the radial head obscured the area of the capitellum that is 21° anterior to the elbow flexion angle. Similarly, posterior long-axis scans could visualize the capitellum from 45° through the rest of the posterior area at 102° flexion of the elbow: the radial head obscured the area of the capitellum that is 57° posterior to the elbow flexion angle. The radial head obscured a 78° (21° + 57°) arc of the capitellum in ultrasonography.
Conclusions
This study thus clarified the area of the humeral capitellum visible in both anterior and posterior ultrasound scans in the sagittal plane.
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Acknowledgments
We thank Y. Mabuchi at the Department of Anatomy, Nagoya City University (Nagoya, Japan), for performing the dissections. We also thank Y. Nishimori and A. Murase at the Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Science for their contributions.
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The authors declare that they have no conflict of interest.
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Takenaga, T., Goto, H., Nozaki, M. et al. Ultrasound imaging of the humeral capitellum: a cadaveric study. J Orthop Sci 19, 907–912 (2014). https://doi.org/10.1007/s00776-014-0637-9
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DOI: https://doi.org/10.1007/s00776-014-0637-9