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22b - Answer: 52-year-old male presents with right elbow pain

Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
Includes DICOM files

HISTORY: 

This 52-year-old male presents with right elbow and shoulder pain.

(QUIZ ANSWER) IS A FINDING IN THIS CASE: 

Small cyst or pseudocyst in the anterior radial tunnel.

Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.

FINDINGS:

No abnormal bone marrow signal to suggest acute fracture or bony contusion. At the lateral epicondyle of the humerus, there is a horizontally-oriented linear low signal tract, likely representing postoperative change, with blooming artifact noted superficially over the lateral elbow. Moderate thickening of the proximal attachment of the common extensor tendons, diffusely low in signal. Radial collateral ligament and lateral ulnar collateral ligament intact. Common flexor tendon and medial collateral ligament intact. 

Biceps, brachialis and triceps tendons intact. Ulnar nerve grossly normal in signal and morphology. Radial neurovascular bundle unremarkable. 

Normal alignment at the elbow. No elbow joint effusion. No large focal articular cartilage defects. No significant erosive or degenerative changes. No abnormal bursal fluid collections. Muscles are normal in signal and bulk. 

CONCLUSION

Old postoperative changes noted at the lateral elbow. No acute bony or soft tissue abnormality. Small cyst or pseudocyst in the anterior radial tunnel may be incidental but could result in the clinical syndrome of cheiralgia paresthetica.

LESSON 2, TOPIC 66

Case Challenge: Elbow MRI Cases

Case Challenge

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Content reviewed: October 28, 2021

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