ESSR Protocols for Elbow MRI



ESSR guidelines for Elbow MRI Planes

What to look in each plane?

Axial:

  • Muscles & Tendons
  • NV bundles.
  • Proximal radioulnar joint and Annular ligament
  • Ganglion cysts.

Sagittal:

  • Joint articulations.
  • Bony avulsions.
  • Chondral defects.
  • Effusion.
  • Ganglion cysts.
  • Joint/synovium.

Coronal:

  • Collateral ligaments
  • Lateral Ulnar collateral ligament
  • Joint/synovium assessment
  • CEO/CFO

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(Courtesy: Supermedica.com)

FABS:

  • For a full-length view of the distal biceps tendon
(Courtesy: radsource.us)


What to look in each sequenc?

SEQUENCES

USES:

 

T1W 
  • Anatomical Details.
  • Fractures.

PDW
  • Anatomical details.
  • Cartilage assessment.

Fat Suppressed T2 or PD
  • Oedema.
  • Effusion. 
  • Bruising.

T2* weighted
  • Collateral ligaments
  • Cartilage

Arthrograms
  • Loose Bodies.
  • OCD.
  • Deep? Undersurface ligamentous tears.
  • Synovial Plicae

Elbow MRI Checklist

Bone

Soft Tissues
  • Bony Avulsions: 
  • Coronoid process, 
  • Olecranon
  • Loose bodies
  • Fractures
  • Osteochondritis dissecans
  • Osteomyelitis
  • Marrow 
  • (Myeloma/Metastases)

 

 
  • Lateral epicondylitis
  • Medial epicondylitis
  • Tendon injury: Triceps 
  • Tendon injury: Distal Biceps
  • Bicipitoradial bursitis
  • Olecranon bursitis
  • Lipomas
  • Subcutaneous lesions

 

Elbow joint

Nerves
  • Joint effusion and haemarthrosis
  • Inflammatory arthropathies (Synovitis/Erosions)
  • Ganglion cysts
  • PVNS
  • Synovial Osteochondromatosis
  • Septic arthritis

 
  • Ulnar Neuritis (Cubital tunnel syndrome)
  • Median Nerve entrapment syndrome
  • PIN compression 

 

Standard MRI Report

 

D. STANDARD REPORTS

 

 

FINDINGS:


No evidence of joint effusion.

Normal signal intensity of the bone marrow with no focal lesions.

Intact juxta-articular muscles and tendons.

No features of epicondylitis.

Normal proximal radioulnar articulation.

Intact ulnar and radial collateral ligaments.

No definite fracture noted.

Normal signal and thickness of the ulnar nerve.

 

CONCLUSION:

Normal MRI of the elbow with no evidence of fluid collection.