Skip to main content
SpringerLink
Log in

Normvarianten und Pitfalls rund um den Ellenbogen

Normal variants and pitfalls at the elbow joint

  • Leitthema
  • Published:
Der Radiologe Aims and scope Submit manuscript

Zusammenfassung

Das Ellenbogengelenk ist aus 3 unterschiedlichen Knochen mit einem Scharnier- und einem Kugelgelenk zusammengesetzt. Mehrere Nerven, Sehnen und Muskeln verlaufen über das Gelenk. Variationen der Anatomie sind auch am Ellenbogen häufig und können Ursache für bestimmte Pathologien sein. Trotz hoher Qualität der modernen Schnittbildgebung bergen einzelne Normalbefunde in der CT oder MRT bei Unkenntnis das Risiko einer Fehlinterpretation. In diesem Artikel werden häufigere aber auch seltene Normvarianten um das Ellenbogengelenk beschrieben. Die klassischen Fallstricke werden aufgezeigt und veranschaulicht sowie einer eventuellen ähnlich anmutenden Pathologie gegenübergestellt.

Abstract

The elbow joint is comprised of three different bones with a combined hinge and a ball joint. Several nerves, tendons and muscles cross the joint. Anatomical variations at the elbow are common and may be the cause of certain pathologies. Despite the high quality of modern cross-sectional imaging, certain normal findings on CT or MRI have the risk of being misinterpreted. This article describes more common but also rare, normal variants around the elbow joint. Classic pitfalls are illustrated and compared to similar pathological findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2
Abb. 3
Abb. 4
Abb. 5a–c
Abb. 6
Abb. 7
Abb. 8
Abb. 9
Abb. 10
Abb. 11
Abb. 12
Abb. 13
Abb. 14
Abb. 15
Abb. 16
Abb. 17

Literatur

  1. Jeon IH, Micic ID, Yamamoto N, Morrey BF (2008) Osborne-cotterill lesion: an osseous defect of the capitellum associated with instability of the elbow. AJR Am J Roentgenol 191(3):727–729

    Article  Google Scholar 

  2. Osborne G, Cotterill P (1966) Recurrent dislocation of the elbow. J Bone Joint Surg Br 48(2):340–346

    Article  CAS  Google Scholar 

  3. Rosenberg ZS, Blutreich SI, Schweitzer ME, Zember JS, Fillmore K (2008) MRI features of posterior capitellar impaction injuries. AJR Am J Roentgenol 190(2):435–441

    Article  Google Scholar 

  4. Rosenberg ZS, Beltran J, Cheung YY (1994) Pseudodefect of the capitellum: potential MR imaging pitfall. Radiology 191(3):821–823

    Article  CAS  Google Scholar 

  5. Rosenberg ZS, Bencardino J, Beltran J (1997) MR imaging of normal variants and interpretation pitfalls of the elbow. Magn Reson Imaging Clin N Am 5(3):481–499

    CAS  PubMed  Google Scholar 

  6. Timmerman LA, Andrews JR (1994) Undersurface tear of the ulnar collateral ligament in baseball players. A newly recognized lesion. Am J Sports Med 22(1):33–36

    Article  CAS  Google Scholar 

  7. Munshi M, Pretterklieber ML, Chung CB, Haghighi P, Cho JH, Trudell DJ et al (2004) Anterior bundle of ulnar collateral ligament: evaluation of anatomic relationships by using MR imaging, MR arthrography, and gross anatomic and histologic analysis. Radiology 231(3):797–803

    Article  Google Scholar 

  8. Dellon AL (1986) Musculotendinous variations about the medial humeral epicondyle. J Hand Surg Br 11(2):175–181

    CAS  PubMed  Google Scholar 

  9. Masear VR, Hill JJ Jr., Cohen SM (1988) Ulnar compression neuropathy secondary to the anconeus epitrochlearis muscle. J Hand Surg Am 13(5):720–724

    Article  CAS  Google Scholar 

  10. O’Driscoll SW, Horii E, Carmichael SW, Morrey BF (1991) The cubital tunnel and ulnar neuropathy. J Bone Joint Surg Br 73(4):613–617

    Article  Google Scholar 

  11. Jeon IH, Fairbairn KJ, Neumann L, Wallace WA (2005) MR imaging of edematous anconeus epitrochlearis: another cause of medial elbow pain? Skeletal Radiol 34(2):103–107

    Article  Google Scholar 

  12. Oh CS, Chung IH, Koh KS (2000) Anatomical study of the accessory head of the flexor pollicis longus and the anterior interosseous nerve in Asians. Clin Anat 13(6):434–438

    Article  CAS  Google Scholar 

  13. Mahakkanukrauh P, Surin P, Ongkana N, Sethadavit M, Vaidhayakarn P (2004) Prevalence of accessory head of flexor pollicis longus muscle and its relation to anterior interosseous nerve in Thai population. Clin Anat 17(8):631–635

    Article  Google Scholar 

  14. al-Qattan MM (1996) Gantzer’s muscle. An anatomical study of the accessory head of the flexor pollicis longus muscle. J Hand Surg Br 21(2):269–270

    Article  CAS  Google Scholar 

  15. Girdany BR, Golden R (1952) Centers of ossification of the skeleton. Am J Roentgenol Radium Ther Nucl Med 68(6):922–924

    CAS  PubMed  Google Scholar 

  16. Emery KH, Zingula SN, Anton CG, Salisbury SR, Tamai J (2016) Pediatric elbow fractures: a new angle on an old topic. Pediatr Radiol 46(1):61–66

    Article  Google Scholar 

  17. Chen Y, Tam HH (2012) Ossification centres in a radiograph of a child’s elbow. BMJ 345:e6965

    Article  Google Scholar 

  18. DeFroda SF, Hansen H, Gil JA, Hawari AH, Cruz AI Jr. (2017) Radiographic evaluation of common pediatric elbow injuries. Orthop Rev (pavia) 9(1):7030

    Article  Google Scholar 

  19. Patel B, Reed M, Patel S (2009) Gender-specific pattern differences of the ossification centers in the pediatric elbow. Pediatr Radiol 39(3):226–231

    Article  Google Scholar 

  20. Chapman VM, Nimkin K, Jaramillo D (2004) The pre-ossification center: normal CT and MRI findings in the trochlea. Skeletal Radiol 33(12):725–727

    Article  Google Scholar 

  21. Natsis K (2008) Supracondylar process of the humerus: study on 375 Caucasian subjects in Cologne, Germany. Clin Anat 21(2):138–141

    Article  Google Scholar 

  22. Andreisek G, Crook DW, Burg D, Marincek B, Weishaupt D (2006) Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics 26(5):1267–1287

    Article  Google Scholar 

  23. Pecina M, Boric I, Anticevic D (2002) Intraoperatively proven anomalous Struthers’ ligament diagnosed by MRI. Skeletal Radiol 31(9):532–535

    Article  CAS  Google Scholar 

  24. Tillmann B (1978) A contribution to the functional morphology of articular surfaces. Norm Pathol Anat (stuttg) 34:1–50

    CAS  Google Scholar 

  25. Fowler KA, Chung CB (2006) Normal MR imaging anatomy of the elbow. Radiol Clin North Am 44(4):553–567

    Article  Google Scholar 

  26. Rosenberg ZS, Bencardino J, Beltran J (1998) MRI of normal variants and interpretation pitfalls of the elbow. Semin Musculoskelet Radiol 2(2):141–155

    Article  Google Scholar 

  27. Rosenberg ZS, Beltran J, Cheung Y, Broker M (1995) MR imaging of the elbow: normal variant and potential diagnostic pitfalls of the trochlear groove and cubital tunnel. AJR Am J Roentgenol 164(2):415–418

    Article  CAS  Google Scholar 

  28. Obermann WR, Loose HW (1983) The os supratrochleare dorsale: a normal variant that may cause symptoms. AJR Am J Roentgenol 141(1):123–127

    Article  CAS  Google Scholar 

  29. Quinn SF, Haberman JJ, Fitzgerald SW, Traughber PD, Belkin RI, Murray WT (1994) Evaluation of loose bodies in the elbow with MR imaging. J Magn Reson Imaging 4(2):169–172

    Article  CAS  Google Scholar 

  30. Duparc F, Putz R, Michot C, Muller JM, Freger P (2002) The synovial fold of the humeroradial joint: anatomical and histological features, and clinical relevance in lateral epicondylalgia of the elbow. Surg Radiol Anat 24(5):302–307

    Article  CAS  Google Scholar 

  31. Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M (2010) Ligaments and plicae of the elbow: normal MR imaging variability in 60 asymptomatic subjects. Radiology 257(1):185–194

    Article  Google Scholar 

  32. Awaya H, Schweitzer ME, Feng SA, Kamishima T, Marone PJ, Farooki S et al (2001) Elbow synovial fold syndrome: MR imaging findings. AJR Am J Roentgenol 177(6):1377–1381

    Article  CAS  Google Scholar 

  33. Stein JM, Cook TS, Simonson S, Kim W (2011) Normal and variant anatomy of the elbow on magnetic resonance imaging. Magn Reson Imaging Clin N Am 19(3):609–619

    Article  Google Scholar 

  34. Zeiss J, Saddemi SR, Ebraheim NA (1992) MR imaging of the quadriceps tendon: normal layered configuration and its importance in cases of tendon rupture. AJR Am J Roentgenol 159(5):1031–1034

    Article  CAS  Google Scholar 

  35. Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M (2009) Elbow nerves: MR findings in 60 asymptomatic subjects—normal anatomy, variants, and pitfalls. Radiology 252(1):148–156

    Article  Google Scholar 

  36. Baumer P, Dombert T, Staub F, Kaestel T, Bartsch AJ, Heiland S et al (2011) Ulnar neuropathy at the elbow: MR neurography—nerve T2 signal increase and caliber. Radiology 260(1):199–206

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Muskuloskelettale und Traumabildgebung, Kantonsspital Graubünden, Zentrales Röntgeninstitut, Loëstr. 170, 7000, Chur, Schweiz

    D. Müller &  C. Schäffeler

Authors
  1. D. Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Schäffeler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. Müller.

Ethics declarations

Interessenkonflikt

D. Müller und C. Schäffeler geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Müller, D., Schäffeler, C. Normvarianten und Pitfalls rund um den Ellenbogen. Radiologe 58, 1011–1020 (2018). https://doi.org/10.1007/s00117-018-0457-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00117-018-0457-6

Schlüsselwörter

Keywords

Search

Navigation