Non-traumatic Elbow Joint Effusion

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Non-traumatic Elbow Joint Effusion

Authors, Editors, Case Information Author: Miguel Agrait Gonzalez, MD CAQ-SM Affiliation: Centro Medico Episcopal San Lucas Ponce Co Author(s): Adriana Mercado MD Kevina Laureano Cruz MD Senior Editor: Derek Stokes, MD Clinical Vignette: A previously healthy 35-year-old male presents with atraumatic right elbow pain for 2 weeks which began after starting an intense tennis training regimen. He has developed acute worsening of pain with new limitation in elbow extension prompting visit for evaluation. He denies previous injuries to the elbow, and denies history of inflammatory arthropathy. Ultrasound-guided arthrocentesis is performed which yields 12mL of purulent material. He was eventually diagnosed with septic arthritis of the elbow Type of Probe Used: MSK Setting Virtual Linear Probe Unlabeled short axis view of the olecranon fossa post-arthrocentesis Unlabeled short axis view of the olecranon fossa post-arthrocentesis. Labeled short axis view of the olecranon fossa post-arthrocentesis Labeled short axis view of the olecranon fossa shortly after arthrocentesis with no hypoechoic collection inferior to the triceps and olecranon fat pad confirming complete drainage of effusion. Labeled short axis view of the olecranon fossa. Labeled short axis view of the olecranon fossa with evidence of effusion deep to triceps muscle and olecranon fat pad Unlabeled short axis view of the olecranon fossa Unlabeled short axis view of the olecranon fossa Labeled long axis view of the olecranon fossa Labeled long axis image of the olecranon fossa with evidence of a large elbow joint effusion and elevation of the olecranon fat pad visualized inferior to the triceps tendon and muscle which are located in the near field of the image. There is displacement of the posterior fat pad seen in the image. Unlabeled long axis view of the olecranon fossa Unlabeled long axis image of the olecranon fossa. Interpretation Image Interpretation: There is a large joint effusion visualized in the olecranon fossa of the elbow joint. The triceps tendon appears normal, there is no evidence of olecranon bursitis present. Teaching Pearl: The posterior view of the elbow joint, specifically the olecranon fossa or recess is the most sensitive location for the identification of an elbow joint effusion using ultrasound. Imaging can be done in both long axis and short axis with the triceps tendon insertion often utilized as a landmark for probe placement. The exam should be performed with the elbow flexed to 90 degrees. In the setting of an effusion, there may be posterior displacement of the hyperechoic fat pad which correlates to conventional xray visualization of fat pad displacement.
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Authors, Editors, Case Information

Unlabeled short axis view of the olecranon fossa post-arthrocentesis

Labeled short axis view of the olecranon fossa post-arthrocentesis

Labeled short axis view of the olecranon fossa.

Unlabeled short axis view of the olecranon fossa

Labeled long axis view of the olecranon fossa

Unlabeled long axis view of the olecranon fossa

Interpretation

UPCOMING EVENTS

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