MRI of the Elbow: Detailed Anatomy

This webpage presents the anatomical structures found on elbow MRI.

MRI Examination of the Elbow

Magnetic resonance imaging (MRI) is one of the procedures used in examining the joints(1).

Magnetic resonance imaging (MRI) is one of the procedures used in examining the joints(1).

 

Common elbow afflictions are associated with sports injuries(2). Joint disorders and injuries, such as fractures, sprains, arthritis, dislocation, and bursitis (bone cushion disorder), are diagnosed using MRI scans.

Anatomy of the Elbow

The elbow is one of the hinge-type synovial joints in the body or the joints that connect two or more bones and can be flexed or extended(3). 

The ulna (long bone of the forearm), humerus (long bone of the arm from the shoulder), and radius (two large bones of the forearm) are the three bones that make up the elbow(4).

These bones are connected by medial collateral (connective tissue inside the elbow) and lateral collateral (connective tissue outside the elbow) ligaments(5).

 

Tendons connect these bones to the muscle of the arm(6). The elbow’s essential tendons attach to the biceps (muscle in front of the arm) and triceps (muscle at the back of the arm) of the forelimb. 

All the nerves that travel from the shoulder across the elbow signal the muscles to work and relay sensations, like temperature, touch, and pain(7).

Magnetic Resonance Imaging (MRI)

An MRI scan provides a non-invasive examination of the internal organs and structures using magnetic fields and computer-generated radio waves to capture a three-dimensional anatomical image(8-9).

Compared to computed tomography (CT) scans and X-rays, MRI scans present more detailed images of the spinal column, the brain, nerves, ligaments, and tendons(10). MRI images are typically used to examine shoulder and knee injuries(11).

 

MRI scan is also useful in the diagnosis of tumors, spinal cord disorders, aneurysm, multiple sclerosis, stroke, brain injury(12).

The MRI examination of the elbow must include images of the radial and ulnar ligaments, synovium (the soft tissue that lines the tendons and joints), bursae (a fluid-filled sac lining the synovial membrane), and nerves(13). 

This procedure may provide a fast identification of abnormalities in the bones, joints, and other parts of the elbow(14).

Elbow Disorders and Injuries

Sometimes the ligaments, tendons, bones, or muscles attached to the elbow become inflamed, causing pain(15).  

The pain may also be caused by overuse due to hobbies, sports, jobs, or everyday chores that require arm movements(16). However, it may also be associated with more severe joint injuries or disorders.

Elbow Strains

A tear in the fibers of the ligament causes elbow strains(17). This fiber tearing is due to the lack of strength and flexibility of the muscles, ligaments, and tendons that support the elbow(18).

Overusing the elbow may result in the irritation, swelling, or tear of the tendons attached to the muscle and bone(19). Individuals experiencing elbow strains may have difficulty stretching and extending their arms. 

An ice compress can help reduce the strain’s swelling, and wearing a sling for 48 hours may provide support to the injured area(20). If elbow pain ensues, a consultation with a doctor is advised.

 

Epicondylitis (Tennis Elbow)

Tennis elbow is caused by the tendons overloading due to the repetitive motions of the arms and wrist(21). 

It is a more severe strain injury due to the frequent contraction of the forearm muscles(22). This injury may induce a series of small tears in the tendons attached to the muscles(23).

Tennis elbow is most common in carpenters, butchers, plumbers, and painters(24). People with epicondylitis or tennis elbow may have difficulty gripping objects(25).

Elbow Osteoarthritis

Elbow osteoarthritis happens due to the worn-out cartilage of the elbow(26). This condition may result from a previous injury, like an elbow fracture or dislocation(27). 

 

Another cause of elbow osteoarthritis is the unstable elbow due to the injury to its ligaments(28). Symptoms like loss of range of motion and pain, may manifest in people with this condition.

Elbow osteoarthritis patients report locking and grating of the elbow. The grating sensation is caused by the cartilage wearing or damage, while locking may be due to the dislodged cartilage(29).

Steroid medications are mostly used to treat this disorder. However, some patients do not react positively to steroids. Instead, alternative treatments like an injection of hyaluronic acid may provide some pain relief(30).

Conclusion

MRI scans may provide a clear image of the elbow structures using a magnetic field and computer-generated radio waves to examine the skeletal system, tissues, and organs(31). 

These MRI images may be used in the evaluation and diagnosis of injuries and disorders. 

In evaluating the elbow structures, the bursae, ligaments, and synovium MRI images are essential to assess a disorder or injury(32).

References

  1. Sampath, S. C., Sampath, S. C., & Bredella, M. A. (2013). Magnetic resonance imaging of the elbow: a structured approach. Sports health, 5(1), 34–49. https://doi.org/10.1177/1941738112467941
  2. Medline Plus, (n.d.), Elbow Injuries and Disorders, retrieved from https://medlineplus.gov/elbowinjuriesanddisorders.html
  3. Concepts of Biology, (n.d.),  Joints and Skeletal Movement, retrieved from https://opentextbc.ca/biology/chapter/19-3-joints-and-skeletal-movement/
  4. Washington University Physicians, (n.d.), The Anatomy of the Elbow, retrieved from https://www.ortho.wustl.edu/content/Patient-Care/3151/Services/Shoulder-Elbow/Overview/Elbow-Arthroscopy-Information/The-Anatomy-of-the-Elbow.aspx
  5. Ibid.
  6. Ibid.
  7. Ibid.
  8. Mayo Clinic, (n.d.), MRI, retrieved from https://www.mayoclinic.org/tests-procedures/mri/about/pac-20384768
  9. NIH National Institute of Biomedical Imaging and Bioengineering, (n.d.), Magnetic Resonance Imaging (MRI), retrieved from https://www.nibib.nih.gov/science-education/science-topics/magnetic-resonance-imaging-mri
  10. Ibid.
  11. Ibid.
  12. Mayo Clinic, MRI, Op. Cit.
  13. Sampath, C. S., Op. Cit.
  14. Ibid.
  15. Harvard Health Publishing, (n.d.), Quick fixes for aching elbows, retrieved from https://www.health.harvard.edu/newsletter_article/quick-fixes-for-aching-elbows#:~:text=The%20most%20common%20cause%20of,cause%20tendinitis%2C%22%20says%20Norby.
  16. Mayo Clinic, (n.d.), Elbow Pain, retrieved from https://www.mayoclinic.org/symptoms/elbow-pain/basics/causes/sym-20050874
  17. NYU Langone Health, (n.d.), Diagnosing Elbow Sprains & Strains, retrieved from https://nyulangone.org/conditions/elbow-sprains-strains/diagnosis#:~:text=Some%20elbow%20sprains%20and%20strains,during%20movement%20or%20at%20rest.
  18. Ibid.
  19. Ibid.
  20. Michigan Medicine, (n.d.), Elbow Injuries, retrieved from https://www.uofmhealth.org/health-library/elbow#aa137159
  21. Mayo Clinic, (n.d.), Tennis elbow, retrieved from https://www.mayoclinic.org/diseases-conditions/tennis-elbow/symptoms-causes/syc-20351987
  22. Ibid.
  23. Ibid.
  24. Ibid.
  25. Ibid.
  26. Ortho Info, American Academy of Orthopedic Surgeon, (n.d.), Osteoarthritis of the Elbow, retrieved from https://orthoinfo.aaos.org/en/diseases–conditions/osteoarthritis-of-the-elbow/#:~:text=Osteoarthritis%20of%20the%20elbow%20occurs,cartilage%20from%20age%20and%20activity.
  27. Ibid.
  28. Ibid.
  29. Ibid.
  30. Ibid.
  31. Mayo Clinic, Op. Cit.
  32. Sampath, C. S., Op. Cit.
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