Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Case 19 Pseudodefect of the capitellum versus osteochondral defect
- Case 20 Pseudodefect of the trochlear groove versus fracture
- Case 21 Transverse trochlear ridge versus osteophyte or post-traumatic deformity
- Case 22 FABS positioning on MRI: demonstration of distal biceps tear
- Case 23 Ulnar collateral ligament tear versus normal recess of the elbow
- Case 24 T-sign of undersurface partial tear of the ulnar collateral ligament
- Case 25 Lateral ulnar collateral ligament tears
- Case 26 Locations and evaluation of loose bodies in the elbow joint
- Case 27 Osteochondritis dissecans of the elbow: stable versus unstable
- Case 28 Little Leaguer’s elbow: what is it?
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Index
- References
Case 26 - Locations and evaluation of loose bodies in the elbow joint
from Section 3 - Elbow
Published online by Cambridge University Press: 05 July 2013
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- Section 1 Shoulder
- Section 2 Arm
- Section 3 Elbow
- Case 19 Pseudodefect of the capitellum versus osteochondral defect
- Case 20 Pseudodefect of the trochlear groove versus fracture
- Case 21 Transverse trochlear ridge versus osteophyte or post-traumatic deformity
- Case 22 FABS positioning on MRI: demonstration of distal biceps tear
- Case 23 Ulnar collateral ligament tear versus normal recess of the elbow
- Case 24 T-sign of undersurface partial tear of the ulnar collateral ligament
- Case 25 Lateral ulnar collateral ligament tears
- Case 26 Locations and evaluation of loose bodies in the elbow joint
- Case 27 Osteochondritis dissecans of the elbow: stable versus unstable
- Case 28 Little Leaguer’s elbow: what is it?
- Section 4 Forearm
- Section 5 Wrist
- Section 6 Hand
- Section 7 Hip and Pelvis
- Section 8 Thigh
- Section 9 Leg
- Section 10 Ankle
- Section 11 Foot
- Section 12 Tumors/Miscellaneous
- Index
- References
Summary
Imaging description
Loose bodies in the elbow are most commonly found in the anterior aspect of the joint within the coronoid fossa/recess (Figure 26.1). The second most common location is within the olecranon fossa/recess, posteriorly. On radiographs, ossified loose bodies can be seen as a typically round or ovoid osseous fragment (Figure 26.1). Non-ossified loose bodies (as well as ossified loose bodies) can be seen on CT arthrography or MRI. Ossified loose bodies on MRI can have fatty signal similar to fatty marrow. In general, loose bodies are seen as filling defects on CT arthrography. They can also be seen easily on MRI if there is fluid within the joint space of the elbow. In regard to imaging, CT arthrography has the best combined sensitivity (between 90–99%) and specificity (60–70%) for detecting elbow loose bodies. Radiographs have a similar specificity (but lower sensitivity) while MRI has a similar sensitivity (but lower specificity). Ultrasound (US) arthrography has also been reported to be more accurate than conventional US in the detection of loose bodies in the elbow.
Importance
Medical imaging plays an important role in the evaluation of the patient with limited range of motion of unknown etiology. One of the causes of this is the presence of an intra-articular loose body. Radiography is the initial imaging test of choice. If this is non-contributory and a loose body is clinically suspected, then CT arthrography would be the most helpful in accurately identifying a loose body. If the reason for the loss of range of motion is unknown, then MR would typically be the best imaging study (after radiography) given its overall utility in better identifying multiple different causes of elbow pathology (relative to US or CT arthrography).
- Type
- Chapter
- Information
- Pearls and Pitfalls in Musculoskeletal ImagingVariants and Other Difficult Diagnoses, pp. 53 - 54Publisher: Cambridge University PressPrint publication year: 2013