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abstract
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PURPOSE
To prospectively evaluate the normal variability of ligaments,
plicae, and the posterior capitellum on conventional magnetic
resonance (MR) images of the elbow in asymptomatic volunteers.
MATERIALS AND METHODS
The study was approved by the institutional ethics board, and
informed consent was obtained from all subjects. MR imaging was
performed at 1.5 T in 60 asymptomatic volunteers (30 women, 30 men;
age range, 22-51 years; median age, 32.8 years) by using the
following five pulse sequences: transverse T1-weighted spin-echo,
sagittal T2-weighted fast spin-echo, coronal fast spin-echo
short-inversion-time inversion recovery, transverse
intermediate-weighted with fat saturation, and coronal
three-dimensional water-excitation true fast imaging with
steady-state precession. The visibility (completely visible over the
entire course, partially visible, or not visible) and signal
intensity characteristics (hypointense or hyperintense to muscle,
homogeneous signal intensity vs striation) of the elbow ligaments
and plicae were evaluated by three independent readers. The presence
of pseudodefects at the posterior capitellum was determined. The
dimensions of all structures were measured by two independent
readers.
RESULTS
The anterior ulnar collateral ligament (UCL) and radial collateral
ligament (RCL) were visible over their entire course in all 60
subjects (100%). The posterior UCL, lateral UCL, and annular
ligament (AL) were completely visible in 58 (97%), 51 (85%), and 59
(98%) of the 60 subjects, respectively, and partially visible in the
remaining subjects. Increased signal intensity with fluid-sensitive
sequences was found in the anterior UCL in nine of the 60 subjects
(15%), posterior UCL in four subjects (7%), RCL in one subject (2%),
lateral UCL in six subjects (10%), and AL in one subject (2%). The
median thickness and 90th percentile were 2.5 and 3.5 mm,
respectively, for the anterior UCL, 1.0 and 1.7 mm for the posterior
UCL, 1.9 and 2.8 mm for the RCL, 2.3 and 3.8 mm for the lateral UCL,
and 1.0 and 1.3 mm for the AL. A posterolateral plica (median
dimension, 4.3 × 1.9 × 3.9 mm) was found in 59 of the 60
subjects (98%), whereas a posterior plica (median dimension, 1.8
× 1.4 mm) could be detected in only 20 (33%). A pseudodefect
of the capitellum was noted in 51 of the 60 subjects (85%).
CONCLUSION
The elbow ligaments and the posterolateral plica are consistently
visible on conventional MR images of asymptomatic subjects. Most
normal ligaments are thinner than 4 mm, and most plicae are thinner
than 3 mm.
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