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Acta cir. bras ; 35(10): e202001007, 2020. tab, graf
Article in English | LILACS | ID: biblio-1130616


Abstract Purpose: Previous studies have questioned whether the triceps brachii muscle tendon (TBMT) has a double or single insertion on the ulna. Aiming to provide an answer, we describe the anatomy of the TBMT and review a magnetic resonance imaging (MRI) series of the elbow. Methods: Forty-one elbows were dissected to assess the details of the triceps brachii insertion. Elbow plastination slices were analyzed to determine whether there was a space on the TBMT. Magnetic resonance imaging from the records of the authors were also obtained to demonstrate the appearance of the pre-tricipital space on MRI. Results: A virtual space on the medial aspect near the TBTM insertion site in the olecranon was consistently found on anatomic dissections. It was a distal pre-tricipital space. Magnetic resonance imaging demonstrated the appearance of the pre-tricipital space on MRI, and its extension was measured longitudinally either in elbow flexion or extension. There was no statistically significant difference between the measurements of this space in the right and left elbows or between flexion and extension (p > 0.05). The coefficient of variation was <10% for all measurements. Conclusion: Knowledge of this structure may be essential to avoid incorrect diagnosis and unnecessary therapeutic interventions.

Muscle, Skeletal/diagnostic imaging , Elbow Joint/diagnostic imaging , Tendons/diagnostic imaging , Magnetic Resonance Imaging , Elbow
Einstein (Säo Paulo) ; 17(3): eAO4579, 2019. tab, graf
Article in English | LILACS | ID: biblio-1012005


ABSTRACT Objective: To determine the value of ultrasonography in elbow ligament assessment compared to magnetic resonance imaging. Methods: A prospective single-center study involving 30 volunteers with no elbow joint changes. Two experienced ultrasound specialists evaluated both elbows of each volunteer, resulting in 60 evaluations per physician and totaling up 120 evaluations. Magnetic resonance images were obtained using a 3-Tesla machine and evaluated by two experienced radiologists, totaling up 120 exams. Each examiner assigned subjective, zero-to-5 scores to ligaments imaged, where zero corresponded to non-identified ligament and 5 to visualization of the entire ligament. The level of significance was set at 5%. Bland-Altman dispersions and plots were prepared for each pair of measurements obtained. Results: All ligaments were amenable to sonographic identification; scores of 4 or 5 were assigned by examiners based on ligament visibility. Ligaments could also be identified using magnetic resonance imaging and were assigned scores of 5 by examiners. All ligaments were described as intact and healthy by all four examiners. Comparative analysis of elbow ligament sonographic and magnetic resonance imaging findings did not differ significantly. Conclusion: Ultrasonography and magnetic resonance imaging can be considered equivalent modalities for elbow ligament assessment in the hands of experienced examiners.

RESUMO Objetivo: Avaliar o desempenho da ultrassonografia na avaliação dos ligamentos do cotovelo, comparando os achados com ressonância magnética. Métodos: Estudo prospectivo unicêntrico envolvendo 30 pacientes, sem alterações articulares nos cotovelos. Dois ultrassonografistas experientes avaliaram ambos os cotovelos de cada um dos pacientes, com 60 avaliações cada médico e 120 avaliações no total. As imagens de ressonância magnética foram obtidas em aparelhos 3 Tesla. Dois radiologistas experientes avaliaram as imagens, com total de 120 exames. Cada examinador deu uma nota subjetiva, de zero a 5, para os ligamentos avaliados; zero correspondeu a ligamento não identificado, e 5 a ligamento visualizado integralmente. Foi considerado nível de significância de 5%. Para cada par de medidas obtidas, construíram-se dispersões e parcelas de Bland-Altman. Resultados: Todos os ligamentos foram identificados pelos examinadores de ultrassonografia, recebendo pontuação 4 ou 5, em relação à sua visibilidade, e foram identificados pelos examinadores de ressonância magnética, com pontuação 5. Foram considerados intactos e saudáveis pelos quatro examinadores. As comparações entre ultrassonografia e ressonância magnética na avaliação dos ligamentos do cotovelo não demostraram diferenças significativas. Conclusão: Quando realizada por examinadores experientes, a ultrassonografia pode ser considerada semelhante à ressonância magnética na avaliação de ligamentos do cotovelo.

Humans , Magnetic Resonance Imaging/methods , Ultrasonography/methods , Elbow Joint/diagnostic imaging , Ligaments, Articular/diagnostic imaging , Reference Values , Prospective Studies , Reproducibility of Results , Elbow Joint/anatomy & histology , Ligaments, Articular/anatomy & histology
Arch. argent. pediatr ; 116(4): 630-634, ago. 2018. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-950057


La luxación de la cabeza radial suele asociarse a fractura o deformidad plástica cubital. La luxación aislada es rara. Sin tratamiento, puede evolucionar hacia deformidad cubital en valgo, lesión nerviosa, artrosis precoz y pérdida del rango de movilidad con limitación funcional. Se presenta a un paciente de 9 años que sufrió traumatismo de codo. Acudió a nuestra Institución a los 40 días y se diagnosticó luxación irreductible de la cabeza radial, primero desapercibida. La luxación era irreductible por un ojal en el ligamento anular y requirió ser reducida a cielo abierto. En ausencia de fractura, incluso sin evidencia de deformidad plástica del cúbito, debe sospecharse la luxación de la cabeza radial. La clínica, junto con el par radiográfico bilateral y el conocimiento de esta entidad poco frecuente, son el trípode necesario para alcanzar el diagnóstico y no demorar el tratamiento.

Anterior radial head dislocation in pediatric population is related to Monteggia fracture-dislocations. Isolated radial head dislocation is uncommon. Sometimes, radial head dislocation becomes irreducible. This entity can develop into chronic conditions such as nerve injuries, early osteoarthritis, limited range of motion and cubitus valgus. We describe a case of a 9-year-old patient who suffered elbow trauma. He was admitted to our institution 40 days after, where radial head dislocation was diagnosed. This condition was misdiagnosed at first stage. It was irreducible due to a tear in the annular ligament. He underwent open reduction. Radial head dislocation must be suspected even if there are no fractures or plastic deformity. Pure irreducible radial head dislocation is rare. Physical examination, together with plain bilateral radiographs and full acknowledgement of this rare condition are the basis to reach early diagnosis, which leads to proper non-delayed treatment.

Humans , Male , Child , Radius/diagnostic imaging , Joint Dislocations/diagnostic imaging , Elbow Joint/diagnostic imaging , Monteggia's Fracture/diagnostic imaging , Radius/pathology , Radiography , Joint Dislocations/pathology , Elbow Joint/injuries , Ligaments, Articular/injuries , Monteggia's Fracture/pathology
Egyptian Orthopaedic Journal [The]. 2007; 42 (1): 19-25
in English | IMEMR | ID: emr-82415


Floating elbow injury in children is uncommon, treatment modalities are controversial; varying between the conservative and the surgical methods. Closed reduction and minimally invasive fixation were the treatment protocol in the current study. Concomitant ipsilateral supracondylar humerus and forearm fractures in 14 children were treated by immediate closed reduction and percutaneous fixation. All fractures were dis-placed, and were open in 3 children. Vascular insufficiency was present in 5; it improved after fractures reduction and fixation. Nerve palsy was diagnosed in 6; it resolved spontaneously within 12 weeks after injury. There was no compartment syndrome.Were assessed clinically and radiographically at a minimum of 18 months after injury. Twelve children had excellent or good and 2 had fair results. Favorable outcome could be obtained with less complications

Humans , Male , Female , Elbow Joint/diagnostic imaging , Elbow Joint/surgery , Fluoroscopy , Child , Treatment Outcome , Follow-Up Studies , Elbow/injuries , Elbow/surgery , Range of Motion, Articular , Fracture Fixation , External Fixators , /injuries , Humeral Fractures , Radius Fractures , Ulna Fractures
Maghreb Medical. 1996; (299): 19-21
in French | IMEMR | ID: emr-41826
Article in English | IMSEAR | ID: sea-87385


Myositis ossificans developing as a complication of tetanus is very rare. There are only nine cases reported so far. We report here a case of a young female who developed myositis ossificans in both the elbow joints as a complication of severe tetanus.

Adult , Elbow Joint/diagnostic imaging , Female , Foot Injuries , Humans , Myositis Ossificans/diagnostic imaging , Tetanus/complications