MRI findings include bone marrow edema and/or periosteal fluid at the site of abnormality [20]. MRI elbow has the advantage of demonstrating associated soft tissue injuries. US Elbow US can demonstrate a lipohemarthrosis in children with occult elbow fractures [23]. However, poor penetration of sound through the bone limits characterization of fractures. Variant 4: Chronic elbow pain. Suspect chronic epicondylalgia or tendon tear. Refractory to empirical treatment. Radiographs normal or nonspecific. Next imaging study. 3-Phase Bone Scan Elbow Although there is limited evidence to support the routine use of 3-phase bone scan in this setting, bone scans can detect chronic epicondylalgia [24]. CT Arthrography Elbow There is limited evidence to the support the use of CT arthrography elbow for the detection of tendon tears or chronic epicondylalgia. CT Elbow There is limited evidence to the support the use of CT elbow for detection of tendon tears or chronic epicondylalgia. MR Arthrography Elbow MR arthrography does not add additional information compared with noncontrast MRI for the diagnosis of biceps tendon tear or chronic epicondylalgia [25]. Chronic Elbow Pain MRI Elbow MRI has high inter- and intraobserver reliability for the diagnosis of epicondylalgia [26]. It also has a sensitivity of 90% to 100% and a specificity of 83% to 100% [27]. The most specific findings of medial epicondylalgia include intermediate to high T2 signal or high T2 signal within the common flexor tendon and paratendinous soft tissue edema [28]. MRI has the benefit of demonstrating associated findings in epicondylalgia, including radial collateral and lateral UCL injuries [26]. MRI may also facilitate surgical planning [29]. MRI is useful for the diagnosis of biceps tendon injury. Sensitivity and specificity are reported at 92.4% and 100%, respectively, in detecting distal biceps tendon ruptures and 59.1% and 100%, respectively for partial tears [30].
Chronic Elbow Pain. MRI findings include bone marrow edema and/or periosteal fluid at the site of abnormality [20]. MRI elbow has the advantage of demonstrating associated soft tissue injuries. US Elbow US can demonstrate a lipohemarthrosis in children with occult elbow fractures [23]. However, poor penetration of sound through the bone limits characterization of fractures. Variant 4: Chronic elbow pain. Suspect chronic epicondylalgia or tendon tear. Refractory to empirical treatment. Radiographs normal or nonspecific. Next imaging study. 3-Phase Bone Scan Elbow Although there is limited evidence to support the routine use of 3-phase bone scan in this setting, bone scans can detect chronic epicondylalgia [24]. CT Arthrography Elbow There is limited evidence to the support the use of CT arthrography elbow for the detection of tendon tears or chronic epicondylalgia. CT Elbow There is limited evidence to the support the use of CT elbow for detection of tendon tears or chronic epicondylalgia. MR Arthrography Elbow MR arthrography does not add additional information compared with noncontrast MRI for the diagnosis of biceps tendon tear or chronic epicondylalgia [25]. Chronic Elbow Pain MRI Elbow MRI has high inter- and intraobserver reliability for the diagnosis of epicondylalgia [26]. It also has a sensitivity of 90% to 100% and a specificity of 83% to 100% [27]. The most specific findings of medial epicondylalgia include intermediate to high T2 signal or high T2 signal within the common flexor tendon and paratendinous soft tissue edema [28]. MRI has the benefit of demonstrating associated findings in epicondylalgia, including radial collateral and lateral UCL injuries [26]. MRI may also facilitate surgical planning [29]. MRI is useful for the diagnosis of biceps tendon injury. Sensitivity and specificity are reported at 92.4% and 100%, respectively, in detecting distal biceps tendon ruptures and 59.1% and 100%, respectively for partial tears [30].