MRI Elbow MRI elbow may detect loose bodies, and this is enhanced in the presence of joint fluid. Thus, T2-weighted images are recommended for the evaluation of loose bodies in the elbow [17]. MRI may also show the presence of enlarged plica, which can result in symptoms of locking and/or pain with extension [15]. MRI is often suggested as the initial study to assess for osteochondral lesion [12,17]. MRI is less sensitive than radiographs in the detection of heterotopic ossification/calcification [18]. Similar to MR arthrography, MRI elbow is limited in the evaluation of cartilage defects [16]. US Elbow Although US may demonstrate early-stage osteochondral lesions and medial epicondylar fragmentation [10], the details of an osteochondral lesion are better defined by CT arthrography or MR arthrography. Because of shadowing, evaluation of heterotopic ossification and loose bodies is limited on US. Variant 3: Chronic elbow pain. Suspect occult stress fracture or other bone abnormality. Radiographs normal or nonspecific. Next imaging study. 3-Phase Bone Scan Elbow Bone scan is extremely sensitive for detection of stress fractures and trauma related fractures [19-21]. Radiopharmaceutical uptake occurs in areas of active bone turnover, and thus, imaging may be positive in the presymptomatic stage of stress injuries [20]. CT Arthrography Elbow There is limited evidence to the support the use of CT arthrography elbow for the detection of occult fractures following radiographs. CT Elbow CT elbow is helpful in identifying complex fracture patterns, the origin of dislocated fragments, and positions of displaced fragments [22]. However, it has poor sensitivity in the detection of early stress fractures [20]. MR Arthrography Elbow There is limited evidence to the support the use of MR arthrography elbow for the detection of occult fractures following radiographs. MRI Elbow MRI is as sensitive as 3-phase bone scan for detection of stress fractures [20].
Chronic Elbow Pain. MRI Elbow MRI elbow may detect loose bodies, and this is enhanced in the presence of joint fluid. Thus, T2-weighted images are recommended for the evaluation of loose bodies in the elbow [17]. MRI may also show the presence of enlarged plica, which can result in symptoms of locking and/or pain with extension [15]. MRI is often suggested as the initial study to assess for osteochondral lesion [12,17]. MRI is less sensitive than radiographs in the detection of heterotopic ossification/calcification [18]. Similar to MR arthrography, MRI elbow is limited in the evaluation of cartilage defects [16]. US Elbow Although US may demonstrate early-stage osteochondral lesions and medial epicondylar fragmentation [10], the details of an osteochondral lesion are better defined by CT arthrography or MR arthrography. Because of shadowing, evaluation of heterotopic ossification and loose bodies is limited on US. Variant 3: Chronic elbow pain. Suspect occult stress fracture or other bone abnormality. Radiographs normal or nonspecific. Next imaging study. 3-Phase Bone Scan Elbow Bone scan is extremely sensitive for detection of stress fractures and trauma related fractures [19-21]. Radiopharmaceutical uptake occurs in areas of active bone turnover, and thus, imaging may be positive in the presymptomatic stage of stress injuries [20]. CT Arthrography Elbow There is limited evidence to the support the use of CT arthrography elbow for the detection of occult fractures following radiographs. CT Elbow CT elbow is helpful in identifying complex fracture patterns, the origin of dislocated fragments, and positions of displaced fragments [22]. However, it has poor sensitivity in the detection of early stress fractures [20]. MR Arthrography Elbow There is limited evidence to the support the use of MR arthrography elbow for the detection of occult fractures following radiographs. MRI Elbow MRI is as sensitive as 3-phase bone scan for detection of stress fractures [20].