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Ultrasonography of the elbow joint
Last reviewed: 20.11.2021
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Since the elbow joint is relatively small and superficially located, it is very convenient for examination by ultrasound (ultrasound). It can even be said that ultrasound is the method of choice in the study of this joint due to its simplicity of implementation, informative and economical. Usually a sensor with a scanning frequency of 7.5 MHz is used.
Anatomy of the elbow joint
The ulnar joint is formed by the joint surface of the lower epiphysis of the humerus, its block and head, as well as the articular surfaces of the ulna and radius. In the cavity of the elbow joint, three joints are distinguished: shoulder-elbow, shoulder-ray and ray-ulnar. The joint capsule covers the elbow joint from all sides. Stabilize the elbow joint lateral ligament: ulnar and radial collateral. Also there is a radial circular ligament, strengthening the elbow-elbow joint and ensuring the stability of the relationship between the radial and ulnar bones during pronation and supination of the forearm. The anterior and posterior sections of the elbow joint are strengthened with bundles insufficiently. Bony benchmarks for the examination of the elbow joint are the medial and lateral epicondyle of the humerus, the ulnar process of the ulna. On the anterior medial surface, the bone marrow is served by the tuberosity of the radial bone and the coronary process of the ulna.
Method of ultrasound examination
Structures that are subject to ultrasound evaluation in the elbow joint: the joint cavity itself, articular cartilage, articular capsule; tendons of muscles involved in the processes of flexion and extension of the joint; medial and lateral epicondyle, ulnar nerve. Ultrasonography (ultrasound) of the elbow joint is performed from four standard approaches: anterior, medial, lateral and posterior. Two options of the patient are used for the elbow joint examination: sitting or lying down.
Methods of ultrasound of the elbow joint
Ultrasonic diagnostics of injuries and diseases of the elbow joint
Epicondylitis. A common disease characterized by pain in the supracondylosis of the humerus. It is often found in people whose profession is associated with repetitive movements of hands, especially pronation and supination (typists, musicians), or with physical stress on the hands at a certain static position of the body (locksmiths, dentists), as well as athletes (tennis players, golfers) . In clinical course, acute and chronic stages are distinguished. In the acute stage, the pain has a permanent character in the region of one of the epicondyles, radiates along the muscles of the forearm, the function of the elbow joint may be disrupted. There is pain in the compression of the hand, the inability to hold the hand in the extended position (symptom of Thompson), the retention of the load on the arm (symptom of fatigue), there is weakness in the hand. In the subacute stage and chronic course of pain arise during exercise, have a dull, aching character. Noticeable hypotrophy or muscle atrophy.
The most typical pathological condition is the lateral epicondylitis or the so-called "tennis elbow". The medial epicondylitis is called the "golf elbow" or "pitcher's elbow." Both these states arise from traumatic and inflammatory conditions in the fibers of the tendons of the corresponding muscle groups. Medial epicondylitis is associated with changes in flexor tendons. Lateral epicondylitis is associated with the pathology of the tendons of the extensor muscles. With the development of tendinitis, the tendon thickens, its echogenicity decreases. The structure may be heterogeneous with the presence of calcifications and hypoechoic areas reflecting intrasuperbial micro-ruptures. The pathological process at the onset of the disease has the character of aseptic inflammation of the periosteum and tendon-ligamentous apparatus in the shoulder epicondyle. In the future, degenerative-degenerative processes develop. Radiographically, about a third of patients, periosteal growths in the region of the epicondylitis, ulnar spurs, dilatations of the bone structure of the epicondyle, areas of the enostosis, etc., are revealed.