Download PDF
Semin Musculoskelet Radiol 2023; 27(02): 163-168
DOI: 10.1055/s-0043-1761957
Review Article

Imaging of Anatomical Variants Around the Elbow

Vito Chianca
1   Clinica di Radiologia EOC IIMSI, Lugano, Switzerland
2   Ospedale Evangelico Betania, Naples, Italy
,
Reto Sutter
3   Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
,
Filippo Del Grande
1   Clinica di Radiologia EOC IIMSI, Lugano, Switzerland
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Corrected by:

Erratum: Imaging of Anatomical Variants Around the ElbowSemin Musculoskelet Radiol 2023; 27(02): e1-e1
DOI: 10.1055/s-0043-1769012

Abstract

The elbow is a synovial joint able to perform flexion, extension, supination, and pronation. Knowledge of anatomical variants is crucial to avoid misinterpretation during the evaluation of the elbow joint. We address those anatomical variants simulating pathologic conditions.

Keywords

elbow - normal - anatomy - variant - ultrasonography


Publication History

Article published online:
03 April 2023

© 2023. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Sconfienza LM, Albano D, Allen G. et al. Clinical indications for musculoskeletal ultrasound updated in 2017 by European Society of Musculoskeletal Radiology (ESSR) consensus. Eur Radiol 2018; 28 (12) 5338-5351
    CrossrefPubMedGoogle Scholar
  • 2 Athwal GS, Steinmann SP, Rispoli DM. The distal biceps tendon: footprint and relevant clinical anatomy. J Hand Surg Am 2007; 32 (08) 1225-1229
    Google Scholar
  • 3 Szewczyk B, Paulsen F, LaPrade RF, Borowski A, Zielinska N, Olewnik Ł. Anatomical variations of the biceps brachii insertion: a proposal for a new classification. Folia Morphol (Warsz) 2022 March 3 (Epub ahead of print)
    PubMedGoogle Scholar
  • 4 Dirim B, Brouha SS, Pretterklieber ML. et al. Terminal bifurcation of the biceps brachii muscle and tendon: anatomic considerations and clinical implications. AJR Am J Roentgenol 2008; 191 (06) W248–W255
    CrossrefPubMedGoogle Scholar
  • 5 Dellon AL. Musculotendinous variations about the medial humeral epicondyle. J Hand Surg [Br] 1986; 11 (02) 175-181
    CrossrefPubMedGoogle Scholar
  • 6 Erdem Bagatur A, Yalcin MB, Ozer UE. Anconeus epitrochlearis muscle causing ulnar neuropathy at the elbow: clinical and neurophysiological differential diagnosis. Orthopedics 2016; 39 (05) e988-e991
    CrossrefPubMedGoogle Scholar
  • 7 O'Hara JJ, Stone JH. Ulnar nerve compression at the elbow caused by a prominent medial head of the triceps and an anconeus epitrochlearis muscle. J Hand Surg [Br] 1996; 21 (01) 133-135
    CrossrefPubMedGoogle Scholar
  • 8 Jeon IH, Fairbairn KJ, Neumann L, Wallace WA. MR imaging of edematous anconeus epitrochlearis: another cause of medial elbow pain?. Skeletal Radiol 2005; 34 (02) 103-107
    CrossrefPubMedGoogle Scholar
  • 9 Kijowski R, Tuite M, Sanford M. Magnetic resonance imaging of the elbow. Part I: normal anatomy, imaging technique, and osseous abnormalities. Skeletal Radiol 2004; 33 (12) 685-697
    CrossrefPubMedGoogle Scholar
  • 10 Tomsick SD, Petersen BD. Normal anatomy and anatomical variants of the elbow. Semin Musculoskelet Radiol 2010; 14 (04) 379-393
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Olewnik Ł, Wysiadecki G, Polguj M, Podgórski M, Jezierski H, Topol M. Anatomical variations of the palmaris longus muscle including its relation to the median nerve—a proposal for a new classification. BMC Musculoskelet Disord 2017; 18 (01) 539
    CrossrefPubMedGoogle Scholar
  • 12 Pires L, Perissé JP, Araújo GCS, Manaia J, Fonseca Júnior A, Babinski MA. Hypertrophic reversed palmaris longus muscle: a cadaveric finding. Folia Morphol (Warsz) 2018; 77 (02) 403-405
    CrossrefPubMedGoogle Scholar
  • 13 Marpalli S, Bhat ALS, Gadahad MRK. A case of reverse palmaris longus muscle—an additional muscle in the anterior compartment of the forearm. J Clin Diagn Res 2016; 10 (03) AD03-AD04
    PubMedGoogle Scholar
  • 14 Murabit A, Gnarra M, Mohamed A. Reversed palmaris longus muscle: anatomical variant—case report and literature review. Can J Plast Surg 2013; 21 (01) 55-56
    CrossrefPubMedGoogle Scholar
  • 15 Pai MM, Nayak SR, Krishnamurthy A. et al. The accessory heads of flexor pollicis longus and flexor digitorum profundus: incidence and morphology. Clin Anat 2008; 21 (03) 252-258
    CrossrefPubMedGoogle Scholar
  • 16 Stein JM, Cook TS, Simonson S, Kim W. Normal and variant anatomy of the elbow on magnetic resonance imaging. Magn Reson Imaging Clin N Am 2011; 19 (03) 609-619
    CrossrefPubMedGoogle Scholar
  • 17 Tagliafico AS, Bignotti B, Martinoli C. Elbow US: anatomy, variants, and scanning technique. Radiology 2015; 275 (03) 636-650
    CrossrefPubMedGoogle Scholar
  • 18 Callaway GH, Field LD, Deng XH. et al. Biomechanical evaluation of the medial collateral ligament of the elbow. J Bone Joint Surg Am 1997; 79 (08) 1223-1231
    CrossrefPubMedGoogle Scholar
  • 19 Beckett KS, McConnell P, Lagopoulos M, Newman RJ. Variations in the normal anatomy of the collateral ligaments of the human elbow joint. J Anat 2000; 197 (Pt 3): 507-511
    CrossrefPubMedGoogle Scholar
  • 20 Konin GP, Nazarian LN, Walz DM. US of the elbow: indications, technique, normal anatomy, and pathologic conditions. Radiographics 2013; 33 (04) E125-E147
    CrossrefPubMedGoogle Scholar
  • 21 Sanal HT, Chen L, Haghighi P, Trudell DJ, Resnick DL. Annular ligament of the elbow: MR arthrography appearance with anatomic and histologic correlation. AJR Am J Roentgenol 2009; 193 (02) W122-W126
    CrossrefPubMedGoogle Scholar
  • 22 Berg EE, DeHoll D. The lateral elbow ligaments. A correlative radiographic study. Am J Sports Med 1999; 27 (06) 796-800
    CrossrefPubMedGoogle Scholar
  • 23 Acosta Batlle J, Cerezal L, López Parra MD, Alba B, Resano S, Blázquez Sánchez J. The elbow: review of anatomy and common collateral ligament complex pathology using MRI. Insights Imaging 2019; 10 (01) 43
    CrossrefPubMedGoogle Scholar
  • 24 Alcid JG, Ahmad CS, Lee TQ. Elbow anatomy and structural biomechanics. Clin Sports Med 2004; 23 (04) 503-517 , vii
    CrossrefPubMedGoogle Scholar
  • 25 Rosenberg ZS, Beltran J, Cheung YY. Pseudodefect of the capitellum: potential MR imaging pitfall. Radiology 1994; 191 (03) 821-823
    CrossrefPubMedGoogle Scholar
  • 26 Rosenberg ZS, Beltran J, Cheung Y, Broker M. MR imaging of the elbow: normal variant and potential diagnostic pitfalls of the trochlear groove and cubital tunnel. AJR Am J Roentgenol 1995; 164 (02) 415-418
    CrossrefPubMedGoogle Scholar
  • 27 Kunc V, Kunc V, Černý V, Polovinčák M, Kachlík D. Accessory bones of the elbow: prevalence, localization and modified classification. J Anat 2020; 237 (04) 618-622
    CrossrefPubMedGoogle Scholar
  • 28 Sampaio ML, Schweitzer ME. Elbow magnetic resonance imaging variants and pitfalls. Magn Reson Imaging Clin N Am 2010; 18 (04) 633-642
    CrossrefPubMedGoogle Scholar
  • 29 Pećina M, Borić I, Anticević D. Intraoperatively proven anomalous Struthers' ligament diagnosed by MRI. Skeletal Radiol 2002; 31 (09) 532-535
    CrossrefPubMedGoogle Scholar
  • 30 Agarwal A, Chandra A, Jaipal U, Saini N. Imaging in the diagnosis of ulnar nerve pathologies—a neoteric approach. Insights Imaging 2019; 10 (01) 37
    CrossrefPubMedGoogle Scholar
  • 31 Voin V, Iwanaga J, Sardi JP. et al. Relationship of the median and radial nerves at the elbow: application to avoiding injury during venipuncture or other invasive procedures of the cubital fossa. Cureus 2017; 9 (03) e1094
    PubMedGoogle Scholar
  • 32 Husarik DB, Saupe N, Pfirrmann CWA, Jost B, Hodler J, Zanetti M. Elbow nerves: MR findings in 60 asymptomatic subjects–normal anatomy, variants, and pitfalls. Radiology 2009; 252 (01) 148-156
    CrossrefPubMedGoogle Scholar
  • 33 Wheeler R, DeCastro A. Posterior Interosseous Nerve Syndrome. Treasure Island, FL: StatPearls; 2022: 18
    Google Scholar
  • 34 Benes M, Kachlik D, Kunc V, Kunc V. The arcade of Frohse: a systematic review and meta-analysis. Surg Radiol Anat 2021; 43 (05) 703-711
    CrossrefPubMedGoogle Scholar
  • 35 Ceri T, Podda A, Behr J, Brumpt E, Alilet M, Aubry S. Posterior interosseous nerve of the elbow at the arcade of Frohse: ultrasound appearance in asymptomatic subjects. Diagn Interv Imaging 2019; 100 (09) 521-525
    CrossrefPubMedGoogle Scholar
  • 36 Vijaya Lakshmi G, Paul L, Alex L. A cadaveric study of the arcade of Frohse. Indian J Clin Anat Physiol 2020; 7: 195-200
    CrossrefPubMedGoogle Scholar
  • 37 Jeon A, Kim YG, Kwon SO, Lee JH. Relationship between the branching patterns of the radial nerve and supinator muscle. BioMed Res Int 2021; 2021: 8691114
    CrossrefPubMedGoogle Scholar
  • 38 Becker D, Lopez-Marambio FA, Hammer N, Kieser D. How to avoid posterior interosseous nerve injury during single-incision distal biceps repair drilling. Clin Orthop Relat Res 2019; 477 (02) 424-431
    CrossrefPubMedGoogle Scholar
  • 39 Gilan IY, Gilan VB, Öztürk AH. Evaluation of the supinator muscle and deep branch of the radial nerve: impact on nerve compression. Surg Radiol Anat 2020; 42 (08) 927-933
    CrossrefPubMedGoogle Scholar
  • 40 Seradge H, Tian W, Baer C, Seradge A. The posterior interosseous nerve anatomical variation and surgical consideration—a case report of cadaver study. Hand Surg 1999; 4 (01) 91-94
    CrossrefPubMedGoogle Scholar
  • 41 Catalano O, Nunziata A, Saturnino PP, Siani A. Epitrochlear lymph nodes: anatomy, clinical aspects, and sonography features. Pictorial essay. J Ultrasound 2010; 13 (04) 168-174
    CrossrefPubMedGoogle Scholar
  • 42 Yardimci VH, Yardimci AH. An unusual first manifestation of Hodgkin lymphoma: Epitrochlear lymph node involvement—a case report and brief review of literature. J Investig Med High Impact Case Rep 2017; 5 (02) 2324709617706709
    PubMedGoogle Scholar
  • 43 Gielen J, Wang XL, Vanhoenacker F. et al. Lymphadenopathy at the medial epitrochlear region in cat-scratch disease. Eur Radiol 2003; 13 (06) 1363-1369
    CrossrefPubMedGoogle Scholar
  • 44 Husarik DB, Saupe N, Pfirrmann CWA, Jost B, Hodler J, Zanetti M. Ligaments and plicae of the elbow: normal MR imaging variability in 60 asymptomatic subjects. Radiology 2010; 257 (01) 185-194
    CrossrefPubMedGoogle Scholar
  • 45 Awaya H, Schweitzer ME, Feng SA. et al. Elbow synovial fold syndrome: MR imaging findings. AJR Am J Roentgenol 2001; 177 (06) 1377-1381
    CrossrefPubMedGoogle Scholar
  • 46 Cerezal L, Rodriguez-Sammartino M, Canga A. et al. Elbow synovial fold syndrome. AJR Am J Roentgenol 2013; 201 (01) W88-W96
    CrossrefPubMedGoogle Scholar