Radial Collateral Ligament Tear Of The Elbow

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Radial Collateral Ligament Tear Of The Elbow

Authors, Editors, Case Information Author: Michael Serra-Jovenich, DO, MMSc, CPT Affiliation: Inspira Physical Medicine & Rehabilitation Residency/Rowan-Virtua School of Osteopathic Medicine Co Author(s): Zachary Noll OMS-III; Cameron Taylor DO; Altamash Raja DO, RMSK, CSCS Editor: Adam Lewno, DO Clinical Vignette: A 43-year-old right-hand-dominant female who is an avid weightlifter presented with subacute right lateral elbow pain which worsened after pulling a heavy object (suitcase) from the floor 1-2 months prior. There was tenderness to palpation along the lateral epicondyle and mild laxity with varus stress testing. Type of Probe Used: 15-4 MHz Linear Transducer Unlabeled Long Axis View of the Right Common Extensor Tendon Unlabeled Long Axis View of the Right Common Extensor Tendon Labeled Long Axis View of the Right Common Extensor Tendon Labeled Long Axis View of the Right Common Extensor Tendon Unlabeled Long Axis View of the Right RCL Unlabeled Long Axis View of the Right RCL Labeled Long Axis View of the Right RCL Labeled Long Axis View of the Right RCL with anechoic area in the ligament measuring approximately 0.33 cm x 0.17 cm. Unlabeled Short Axis View of the Right RCL Unlabeled Short Axis View of the Right RCL Labeled Short Axis View of the Right RCL Labeled Short Axis View of the Right RCL with anechoic area measuring approximately 0.20 cm. Unlabeled Short Axis View of the Right Lateral Epicondyle Unlabeled Short Axis View of the Right Lateral Epicondyle Labeled Short Axis View of the Right Lateral Epicondyle Labeled Short Axis View of the Right Lateral Epicondyle with cortical irregularity at lateral epicondyle. #9 - Video View Video Unlabeled long axis cine of the right RCL from anterior to posterior with notable anechoic area in the ligament. #10 - Video View Video Unlabeled short axis cine of the right lateral elbow from proximal to distal anechoic area in the RCL and cortical irregularity of the lateral epicondyle. Interpretation Image Interpretation: A small anechoic region is noted deep to the common extensor tendon along the proximal radial collateral ligament, measuring approximately 0.2 cm x 0.33 cm x 0.17 cm with notable underlying cortical irregularity. No hyperemia is present. The common extensor tendon origin is slightly hypoechoic without thickening or disruption in its fibrillar pattern. These findings are suggestive of a partial thickness tear of the radial collateral ligament with subtle common extensor tendinosis. Teaching Pearl: The radial collateral ligament is one component of the lateral collateral ligament complex, along with the annular ligament and lateral ulnar collateral ligament. Injuries are often traumatic, particularly after elbow dislocation or a fall on an outstretched hand, and commonly involve the proximal ligament near the lateral epicondyle. Ultrasound should assess the proximal attachment, fiber continuity, focal hypoechogenicity, cortical irregularity, and adjacent common extensor tendon. Because lateral elbow pain is often multifactorial, the scan should include the lateral joint, common extensor origin, and radial nerve region as well. References: 1. Jacobson JA, Chiavaras MM, Lawton JM, Downie B, Yablon CM, Lawton J. Radial collateral ligament of the elbow. J Ultrasound Med. 2014;33(6):1041-1048. doi:10.7863/ultra.33.6.1041 2. Teixeira PA, Omoumi P, Trudell DJ, et al. Ultrasound assessment of the lateral collateral ligamentous complex of the elbow: imaging aspects in cadavers and normal volunteers. Eur Radiol. 2011;21(7):1492-1498. doi:10.1007/s00330-011-2076-8 3. Graf DN, Fritz B, Bouaicha S, Sutter R. Elbow instability. Semin Musculoskelet Radiol. 2021;25(4):574-579. doi:10.1055/s-0041-1735467
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Authors, Editors, Case Information

Unlabeled Long Axis View of the Right Common Extensor Tendon

Labeled Long Axis View of the Right Common Extensor Tendon

Unlabeled Long Axis View of the Right RCL

Labeled Long Axis View of the Right RCL

Unlabeled Short Axis View of the Right RCL

Labeled Short Axis View of the Right RCL

Unlabeled Short Axis View of the Right Lateral Epicondyle

Labeled Short Axis View of the Right Lateral Epicondyle

#9 - Video

#10 - Video

Interpretation

UPCOMING EVENTS

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