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Elbow ultrasound
Last reviewed: 05.07.2025
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Since the elbow joint is relatively small and superficially located, it is very convenient for examination using the ultrasound method (US). It can even be said that ultrasound is the method of choice for examining this joint due to its ease of implementation, information content and cost-effectiveness. A sensor with a scanning frequency of 7.5 MHz is usually used.
Anatomy of the elbow joint
The elbow joint is formed by the articular surface of the lower epiphysis of the humerus, its block and head, and the articular surfaces of the ulna and radius. There are three joints in the elbow joint cavity: humeroulontal, humeroradial, and radioulnar. The joint capsule covers the elbow joint on all sides. The elbow joint is stabilized by lateral ligaments: the ulnar and radial collateral ligaments. There is also a radial circular ligament that strengthens the radioulnar joint and ensures stability of the relationship between the radius and ulna during pronation and supination of the forearm. The anterior and posterior sections of the elbow joint are insufficiently strengthened by ligaments. The bony landmarks for examining the elbow joint are the medial and lateral epicondyles of the humerus and the olecranon process of the ulna. On the anteromedial surface, the bony landmarks are the tuberosity of the radius and the coronoid process of the ulna.
Ultrasound examination technique
The structures that are subject to ultrasound evaluation in the elbow joint are: the joint cavity itself, articular cartilage, joint capsule; tendons of the muscles involved in the processes of flexion and extension of the joint; medial and lateral epicondyles, ulnar nerve. Ultrasound examination (US) of the elbow joint is performed from four standard approaches: anterior, medial, lateral and posterior. Two patient positions are used at the patient's discretion when examining the elbow joint: sitting or lying down.
Methodology for performing ultrasound examination of the elbow joint
Ultrasound diagnostics of injuries and diseases of the elbow joint
Epicondylitis. A common disease characterized by pain in the area of the epicondyles of the humerus. It often occurs in people whose profession is associated with monotonous repetitive hand movements, especially pronation and supination (typists, musicians), or with physical stress on the hands in a certain static position of the body (mechanics, dentists), as well as in athletes (tennis players, golfers). In the clinical course, acute and chronic stages are distinguished. In the acute stage, the pain is constant in the area of one of the epicondyles, radiates along the muscles of the forearm, and the function of the elbow joint may be impaired. Pain occurs when squeezing the hand, the inability to hold the arm in an extended position (Thompson symptom), to hold a load on an outstretched arm (fatigue symptom), weakness in the arm appears. In the subacute stage and chronic course, pain occurs under stress, has a dull, aching character. Muscle hypotrophy or atrophy is noticeable.
The most typical pathological condition is lateral epicondylitis or so-called "tennis elbow". Medial epicondylitis is called "golfer's elbow" or "pitcher's elbow". Both of these conditions occur due to traumatic and inflammatory conditions in the fibers of the tendons of the corresponding muscle groups. Medial epicondylitis is associated with changes in the flexor tendons. Lateral epicondylitis is associated with 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 intratendinous micro-tears. The pathological process at the onset of the disease is characterized by aseptic inflammation of the periosteum and tendon-ligament apparatus in the area of the shoulder epicondyles. Degenerative-dystrophic processes develop later. Radiologically, in approximately a third of patients, periosteal growths in the epicondyle area, elbow spurs, rarefaction of the bone structure of the epicondyle, areas of enostosis, etc. are detected.