US Elbow US elbow has moderate agreement with MR elbow for the diagnosis and grading of common extensor tendon tears. US sensitivity, specificity, and accuracy are reported at 64.25%, 85.19%, and 72.73%, respectively [31]. Recently, sonoelastography has shown more promising outcomes for detection of medial epicondylalgia with a sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 95.2%, 92%, 93.5%, 90.9%, and 95.8%, respectively [32]. Another new technique, superb microvascular imaging, can be used to detect subtle low blood flow. The combination of superb microvascular imaging with conventional US performed best for the diagnosis of epicondylalgia, with sensitivity of 94%, specificity of 98%, accuracy of 96% [33]. US is also useful for detection of biceps tendon abnormalities. It performs similar to slightly better than MRI for the diagnosis of distal biceps brachii tendon tear [34]. Reports show 95% sensitivity, 71% specificity, and 91% accuracy for the diagnosis of complete versus partial distal biceps tendon tears with US [35]. Variant 5: Chronic elbow pain. Suspect collateral ligament tear. 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 for the diagnosis of collateral ligament injury following radiographs. CT Arthrography Elbow CT arthrography has a sensitivity of 86%. The sensitivity for full-thickness tears and partial tears is reported at 100% and 71%, respectively. The overall specificity is 91% [36]. CT Elbow There is limited evidence to support the routine use of CT elbow for the diagnosis of collateral ligament injury following radiographs. MR Arthrography Elbow MR arthrography elbow is accurate for the diagnosis of collateral ligament injuries [37]. At 3T, it is more accurate than noncontrast MRI [38]. The reported sensitivity, specificity, and accuracy for UCL tears are 81%, 91%, and 88%, respectively [39].
Chronic Elbow Pain. US Elbow US elbow has moderate agreement with MR elbow for the diagnosis and grading of common extensor tendon tears. US sensitivity, specificity, and accuracy are reported at 64.25%, 85.19%, and 72.73%, respectively [31]. Recently, sonoelastography has shown more promising outcomes for detection of medial epicondylalgia with a sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 95.2%, 92%, 93.5%, 90.9%, and 95.8%, respectively [32]. Another new technique, superb microvascular imaging, can be used to detect subtle low blood flow. The combination of superb microvascular imaging with conventional US performed best for the diagnosis of epicondylalgia, with sensitivity of 94%, specificity of 98%, accuracy of 96% [33]. US is also useful for detection of biceps tendon abnormalities. It performs similar to slightly better than MRI for the diagnosis of distal biceps brachii tendon tear [34]. Reports show 95% sensitivity, 71% specificity, and 91% accuracy for the diagnosis of complete versus partial distal biceps tendon tears with US [35]. Variant 5: Chronic elbow pain. Suspect collateral ligament tear. 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 for the diagnosis of collateral ligament injury following radiographs. CT Arthrography Elbow CT arthrography has a sensitivity of 86%. The sensitivity for full-thickness tears and partial tears is reported at 100% and 71%, respectively. The overall specificity is 91% [36]. CT Elbow There is limited evidence to support the routine use of CT elbow for the diagnosis of collateral ligament injury following radiographs. MR Arthrography Elbow MR arthrography elbow is accurate for the diagnosis of collateral ligament injuries [37]. At 3T, it is more accurate than noncontrast MRI [38]. The reported sensitivity, specificity, and accuracy for UCL tears are 81%, 91%, and 88%, respectively [39].