The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Chronic Elbow Pain Discussion of Procedures by Variant Variant 1: Chronic elbow pain. Initial imaging. 3-Phase Bone Scan Elbow There is limited evidence to support the use of 3-phase bone scan as the initial imaging study for the evaluation of chronic elbow pain. CT Arthrography Elbow There is limited evidence to support the use of CT arthrography elbow as the initial imaging study for the evaluation of chronic elbow pain. CT Elbow There is limited evidence to support the use of CT elbow as the initial imaging study for the evaluation of chronic elbow pain. MR Arthrography Elbow There is limited evidence to support the use of MR arthrography elbow as the initial imaging study for the evaluation of chronic elbow pain. MRI Elbow There is limited evidence to support the use of MRI elbow as the initial imaging study for the evaluation of chronic elbow pain. Radiography Elbow Radiographs are beneficial as the initial imaging for chronic elbow pain. Radiographs may show intra-articular bodies, heterotopic ossification, osteochondral lesion, soft tissue calcification, occult fracture, or osteoarthritis. Radiographs complement subsequent MRI elbow examination [4]. Radiographs have been shown to aide the diagnosis of valgus instability [5] and ulnar collateral ligament (UCL) injury [6]. Comparison with the asymptomatic side is often useful [7]. US Elbow There is limited evidence to support the use of ultrasound (US) elbow as the initial imaging study for the evaluation of chronic elbow pain. Variant 2: Chronic elbow pain with mechanical symptoms such as locking, clicking, or limited range of motion.
Chronic Elbow Pain. The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through representation of such organizations on expert panels. Participation on the expert panel does not necessarily imply endorsement of the final document by individual contributors or their respective organization. Reprint requests to: publications@acr.org Chronic Elbow Pain Discussion of Procedures by Variant Variant 1: Chronic elbow pain. Initial imaging. 3-Phase Bone Scan Elbow There is limited evidence to support the use of 3-phase bone scan as the initial imaging study for the evaluation of chronic elbow pain. CT Arthrography Elbow There is limited evidence to support the use of CT arthrography elbow as the initial imaging study for the evaluation of chronic elbow pain. CT Elbow There is limited evidence to support the use of CT elbow as the initial imaging study for the evaluation of chronic elbow pain. MR Arthrography Elbow There is limited evidence to support the use of MR arthrography elbow as the initial imaging study for the evaluation of chronic elbow pain. MRI Elbow There is limited evidence to support the use of MRI elbow as the initial imaging study for the evaluation of chronic elbow pain. Radiography Elbow Radiographs are beneficial as the initial imaging for chronic elbow pain. Radiographs may show intra-articular bodies, heterotopic ossification, osteochondral lesion, soft tissue calcification, occult fracture, or osteoarthritis. Radiographs complement subsequent MRI elbow examination [4]. Radiographs have been shown to aide the diagnosis of valgus instability [5] and ulnar collateral ligament (UCL) injury [6]. Comparison with the asymptomatic side is often useful [7]. US Elbow There is limited evidence to support the use of ultrasound (US) elbow as the initial imaging study for the evaluation of chronic elbow pain. Variant 2: Chronic elbow pain with mechanical symptoms such as locking, clicking, or limited range of motion.