Reliability of Magnetic Resonance Imaging Signs of Posterolateral Rotatory Instability of the Elbow
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Reliability of Magnetic Resonance Imaging Signs of Posterolateral Rotatory Instability of the Elbow. / Hackl, Michael; Wegmann, Kilian; Ries, Christian; Leschinger, Tim; Burkhart, Klaus Josef; Müller, Lars Peter.
in: J HAND SURG-AM, Jahrgang 40, Nr. 7, 07.2015, S. 1428-33.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Reliability of Magnetic Resonance Imaging Signs of Posterolateral Rotatory Instability of the Elbow
AU - Hackl, Michael
AU - Wegmann, Kilian
AU - Ries, Christian
AU - Leschinger, Tim
AU - Burkhart, Klaus Josef
AU - Müller, Lars Peter
N1 - Copyright © 2015 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
PY - 2015/7
Y1 - 2015/7
N2 - PURPOSE: To evaluate radiographic signs of posterolateral rotatory instability (PLRI) on magnetic resonance imaging (MRI). The goal was to establish objective radiographic criteria to aid in the diagnosis of PLRI.METHODS: The MRI scans of 60 patients were evaluated retrospectively. Two study groups were compared. Group 1 (n = 30) consisted of unstable elbows in which PLRI was confirmed by clinical examination and arthroscopy. Group 2 (stable; n = 30) served as the control group. Patients in group 2 had transient epicondylitis without clinical suspicion of instability. Joint incongruity was analyzed for sagittal views through the radial head and the coronoid tip and for coronal and axial views. Interobserver and intra-observer reliability were evaluated.RESULTS: In the sagittal view through the radial head, average radiocapitellar incongruity differed significantly between groups 1 and 2. In addition, mean ulnohumeral incongruity in an axial view through the motion axis of the distal humerus showed significant differences between groups. Sagittal views through the tip of the coronoid and coronal views did not reveal significant differences in patients with unstable elbows compared with the control group.CONCLUSIONS: The current study provides useful MRI criteria indicative of PLRI when combined with physical examination. Cutoff points of 1.2 mm for radiocapitellar incongruity (sagittal view) and 0.7 mm for axial ulnohumeral incongruity (axial view) are suitable to screen for PLRI. Radiocapitellar incongruity greater than 2 mm and axial ulnohumeral incongruity greater than 1 mm are highly suspicious of elbow instability.TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic IV.
AB - PURPOSE: To evaluate radiographic signs of posterolateral rotatory instability (PLRI) on magnetic resonance imaging (MRI). The goal was to establish objective radiographic criteria to aid in the diagnosis of PLRI.METHODS: The MRI scans of 60 patients were evaluated retrospectively. Two study groups were compared. Group 1 (n = 30) consisted of unstable elbows in which PLRI was confirmed by clinical examination and arthroscopy. Group 2 (stable; n = 30) served as the control group. Patients in group 2 had transient epicondylitis without clinical suspicion of instability. Joint incongruity was analyzed for sagittal views through the radial head and the coronoid tip and for coronal and axial views. Interobserver and intra-observer reliability were evaluated.RESULTS: In the sagittal view through the radial head, average radiocapitellar incongruity differed significantly between groups 1 and 2. In addition, mean ulnohumeral incongruity in an axial view through the motion axis of the distal humerus showed significant differences between groups. Sagittal views through the tip of the coronoid and coronal views did not reveal significant differences in patients with unstable elbows compared with the control group.CONCLUSIONS: The current study provides useful MRI criteria indicative of PLRI when combined with physical examination. Cutoff points of 1.2 mm for radiocapitellar incongruity (sagittal view) and 0.7 mm for axial ulnohumeral incongruity (axial view) are suitable to screen for PLRI. Radiocapitellar incongruity greater than 2 mm and axial ulnohumeral incongruity greater than 1 mm are highly suspicious of elbow instability.TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic IV.
KW - Adult
KW - Aged
KW - Arthroscopy
KW - Contrast Media
KW - Elbow Joint/physiopathology
KW - Female
KW - Humans
KW - Image Interpretation, Computer-Assisted
KW - Joint Instability/physiopathology
KW - Magnetic Resonance Imaging/methods
KW - Male
KW - Middle Aged
KW - Physical Examination
KW - Reproducibility of Results
KW - Retrospective Studies
U2 - 10.1016/j.jhsa.2015.04.029
DO - 10.1016/j.jhsa.2015.04.029
M3 - SCORING: Journal article
C2 - 26095056
VL - 40
SP - 1428
EP - 1433
JO - J HAND SURG-AM
JF - J HAND SURG-AM
SN - 0363-5023
IS - 7
ER -
