MR arthrography may also assist in differentiation between partial and complete UCL tear [40,41]. Presence of soft tissue and bone marrow edema occurs more often in symptomatic patients [42]. Additionally, a more distal ligamentous insertion of the UCL (T sign) has recently been suggested to result from repetitive overhead activity and injury rather than representing a normal anatomic variant [42]. In patients with posterolateral rotatory instability, MR arthrography can assess the integrity of the ulnar band of the radial collateral ligament [43] and demonstrate radiocapitellar incongruity [44]. MRI Elbow A 3T MR arthrography is more accurate than noncontrast MRI elbow for detection of collateral ligament injuries [38]. Radiography Elbow Stress View Measurement of medial joint space opening on stress radiographs correlates with severity of UCL injury in throwing athletes [6]. Additionally, medial joint vacuum phenomenon on valgus stress radiographs is specific for UCL injury [45]. However, radiographs do not directly provide information on the location of collateral ligament injury or associated soft tissue injuries as can be done on MR arthrography. Chronic Elbow Pain US Elbow For full-thickness UCL tears, conventional US has a sensitivity of 79%, a specificity of 98%, and an accuracy of 95% (38). For partial thickness UCL tears, conventional US has a sensitivity of 77%, a specificity of 94%, and an accuracy of 90% (38). Stress US can accurately detect UCL tears when there is medial joint gapping [46,47]. The sensitivity and specificity of valgus stress US for all UCL tears is 96% and 81%, respectively [36]. Variant 6: Chronic elbow pain. Suspect nerve abnormality. Radiographs normal or nonspecific. Next imaging study. 3-Phase Bone Scan Elbow There is limited evidence to support the routine use of 3-phase bone scan elbow for nerve abnormalities at the elbow following radiographs.
Chronic Elbow Pain. MR arthrography may also assist in differentiation between partial and complete UCL tear [40,41]. Presence of soft tissue and bone marrow edema occurs more often in symptomatic patients [42]. Additionally, a more distal ligamentous insertion of the UCL (T sign) has recently been suggested to result from repetitive overhead activity and injury rather than representing a normal anatomic variant [42]. In patients with posterolateral rotatory instability, MR arthrography can assess the integrity of the ulnar band of the radial collateral ligament [43] and demonstrate radiocapitellar incongruity [44]. MRI Elbow A 3T MR arthrography is more accurate than noncontrast MRI elbow for detection of collateral ligament injuries [38]. Radiography Elbow Stress View Measurement of medial joint space opening on stress radiographs correlates with severity of UCL injury in throwing athletes [6]. Additionally, medial joint vacuum phenomenon on valgus stress radiographs is specific for UCL injury [45]. However, radiographs do not directly provide information on the location of collateral ligament injury or associated soft tissue injuries as can be done on MR arthrography. Chronic Elbow Pain US Elbow For full-thickness UCL tears, conventional US has a sensitivity of 79%, a specificity of 98%, and an accuracy of 95% (38). For partial thickness UCL tears, conventional US has a sensitivity of 77%, a specificity of 94%, and an accuracy of 90% (38). Stress US can accurately detect UCL tears when there is medial joint gapping [46,47]. The sensitivity and specificity of valgus stress US for all UCL tears is 96% and 81%, respectively [36]. Variant 6: Chronic elbow pain. Suspect nerve abnormality. Radiographs normal or nonspecific. Next imaging study. 3-Phase Bone Scan Elbow There is limited evidence to support the routine use of 3-phase bone scan elbow for nerve abnormalities at the elbow following radiographs.