Suspect intra-articular pathology such as osteocartilaginous body, osteochondral lesion, or synovial 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 evaluation of osteochondral bodies, osteochondral lesions, or synovial abnormalities. However, the early phase of a 3-phase bone scan can identify the inflammatory component of heterotopic ossification. The delayed images demonstrate increased tracer uptake due to bone formation [8,9]. CT Arthrography Elbow CT arthrography elbow is useful in the assessment of heterotopic ossification, loose bodies, and osteoarthritis. CT elbow has a sensitivity and specificity of 93% and 66% for detection of loose bodies [10]. It has a reported accuracy of 79% for the detection of loose bodies and 76% for osteophytes [10]. However, small intra-articular bodies may be obscured by contrast. CT arthrography is helpful for evaluation of osteochondral lesion stability [11]. CT Elbow CT elbow is useful in the assessment of heterotopic ossification, loose bodies, and osteophytosis. CT elbow has a sensitivity and specificity of 93% and 66% for the detection of loose bodies [10]. CT elbow without intravenous (IV) contrast is less useful than CT arthrography elbow for the assessment of osteochondral lesion stability. MR Arthrography Elbow MRI arthrography elbow is useful for detection of intra-articular bodies, with a reported sensitivity of 100% and a specificity of 67% [12]. MR arthrography elbow also plays an important role in evaluation of osteochondral lesion stability [13,14]. MRI may also show the presence of enlarged synovial plica, which can result in symptoms of locking and/or pain with extension [15]. However, MR arthrography elbow is limited in the detection of cartilage Chronic Elbow Pain abnormalities. Accuracy is reported as 45% for the radius, 64% for the capitellum, 18% for the ulna, and 27% for the trochlea [16].
Chronic Elbow Pain. Suspect intra-articular pathology such as osteocartilaginous body, osteochondral lesion, or synovial 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 evaluation of osteochondral bodies, osteochondral lesions, or synovial abnormalities. However, the early phase of a 3-phase bone scan can identify the inflammatory component of heterotopic ossification. The delayed images demonstrate increased tracer uptake due to bone formation [8,9]. CT Arthrography Elbow CT arthrography elbow is useful in the assessment of heterotopic ossification, loose bodies, and osteoarthritis. CT elbow has a sensitivity and specificity of 93% and 66% for detection of loose bodies [10]. It has a reported accuracy of 79% for the detection of loose bodies and 76% for osteophytes [10]. However, small intra-articular bodies may be obscured by contrast. CT arthrography is helpful for evaluation of osteochondral lesion stability [11]. CT Elbow CT elbow is useful in the assessment of heterotopic ossification, loose bodies, and osteophytosis. CT elbow has a sensitivity and specificity of 93% and 66% for the detection of loose bodies [10]. CT elbow without intravenous (IV) contrast is less useful than CT arthrography elbow for the assessment of osteochondral lesion stability. MR Arthrography Elbow MRI arthrography elbow is useful for detection of intra-articular bodies, with a reported sensitivity of 100% and a specificity of 67% [12]. MR arthrography elbow also plays an important role in evaluation of osteochondral lesion stability [13,14]. MRI may also show the presence of enlarged synovial plica, which can result in symptoms of locking and/or pain with extension [15]. However, MR arthrography elbow is limited in the detection of cartilage Chronic Elbow Pain abnormalities. Accuracy is reported as 45% for the radius, 64% for the capitellum, 18% for the ulna, and 27% for the trochlea [16].