All patients presenting with elbow pain after trauma should have x-rays obtained. These should include antero-posterior (AP) and lateral images. If a proximal radius fracture is suspected, an oblique radial head view can help by removing the osseous overlap of the radial head and coronoid.
It can be difficult to obtain ideal views on the athlete with a painful elbow following trauma. Splints and other materials may also adversely affect the image quality.
Orthopaedic – Prosthetics / Sports Medicine
MRI is generally the modality of choice for further assessment of the elbow. The main indications for an MRI are:
- Clinical signs of fracture, but no radiographic evidence (the so-called occult fracture)
- Ligamentous injuries
- Tendon injuries
- Loose bodies
- Osteochondral lesions
Computed tomography (CT) is useful for assessing intra-articular fractures and to help with pre-operative planning in complex cases. In some cases, 3D reconstruction can improve the understanding of fracture pattern.
Ultrasound scans (USS) can also be very useful in assessing the tendons around the elbow. Tendinopathy, and tendon ruptures, are typically clinical diagnoses but can also be diagnosed using USS. This is also a good tool for the assessment of the peripheral nerves about the elbow.