Introduction
Materials and methods
Paleopathologic investigation
Cadavers and specimen preparation
MR imaging
Radiologic–anatomic correlation
Results
Paleopathologic investigation
Specimen | Supracondylar ridge | Superior epicondylar aspect | Epicondylar ridge | Anterolateral epicondylar face | Anterosuperior tubercle | Type | Intertubercular sulcus | Type | Anteroinferior tubercle | Inferior epicondylar aspect | Posterior epicondylar aspect | Semilunar area |
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 4 | 4 | 4 | 4 | 4 | 2 | 4 | 2 | 4 | 4 | 4 | 4 |
2 | 4 | 4 | 3 | 3 | 3 | 4 | 4 | 1 | 2 | 4 | 4 | 4 |
3 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 1 | 2 | 4 | 4 | 4 |
4 | 4 | 4 | 4 | 4 | 4 | 2 | 3 | 1 | 3 | 4 | 4 | 4 |
5 | 4 | 4 | 4 | 4 | 2 | 2 | 2 | 1 | 1 | 4 | 4 | 4 |
6 | 4 | 4 | 4 | 4 | 3 | 2 | 3 | 1 | 3 | 4 | 4 | 4 |
7 | 4 | 4 | 4 | 4 | 3 | 2 | 3 | 1 | 2 | 4 | 4 | 4 |
8 | 4 | 4 | 3 | 4 | 2 | 2 | 2 | 1 | 2 | 4 | 4 | 4 |
9 | 4 | 4 | 3 | 4 | 2 | 2 | 2 | 2 | 2 | 4 | 4 | 4 |
10 | 4 | 4 | 4 | 4 | 2 | 3 | 2 | 1 | 2 | 4 | 4 | 4 |
11 | 4 | 4 | 4 | 4 | 2 | 2 | 2 | 1 | 2 | 4 | 4 | 4 |
12 | 4 | 4 | 4 | 4 | 1 | na | 2 | 1 | 2 | 4 | 4 | 4 |
13 | 4 | 4 | 2 | 4 | 1 | na | 1 | na | 1 | 4 | 4 | 4 |
14 | 4 | 4 | 4 | 4 | 1 | na | 2 | 1 | 2 | 4 | 4 | 4 |
15 | 4 | 4 | 3 | 3 | 2 | 2 | 2 | 1 | 2 | 4 | 4 | 4 |
16 | 4 | 4 | 3 | 4 | 2 | 2 | 2 | 1 | 1 | 4 | 4 | 4 |
17 | 4 | 4 | 3 | 4 | 2 | 2 | 3 | 2 | 3 | 4 | 4 | 4 |
18 | 3 | 3 | 3 | 3 | 3 | 2 | 3 | 1 | 3 | 4 | 4 | 4 |
19 | 4 | 4 | 3 | 4 | 1 | na | 1 | na | 2 | 4 | 4 | 4 |
20 | 4 | 4 | 4 | 4 | 4 | 2 | 4 | 2 | 4 | 4 | 4 | 4 |
21 | 4 | 4 | 3 | 4 | 2 | 3 | 3 | 1 | 2 | 4 | 4 | 4 |
22 | 3 | 3 | 3 | 4 | 2 | 2 | 2 | 1 | 2 | 4 | 4 | 4 |
23 | 4 | 4 | 4 | 3 | 1 | na | 2 | 1 | 2 | 4 | 4 | 4 |
24 | 4 | 4 | 4 | 4 | 2 | 2 | 2 | 1 | 2 | 4 | 4 | 4 |
25 | 4 | 4 | 4 | 4 | 3 | 2 | 3 | 1 | 3 | 4 | 4 | 4 |
26 | 4 | 4 | 4 | 2 | 1 | na | 1 | na | 1 | 4 | 4 | 4 |
27 | 4 | 4 | 4 | 3 | 2 | 2 | 2 | 1 | 2 | 4 | 4 | 4 |
28 | 4 | 4 | 4 | 4 | 4 | 2 | 4 | 1 | 4 | 4 | 4 | 4 |
29 | 4 | 4 | 4 | 2 | 1 | na | 1 | na | 1 | 4 | 4 | 4 |
30 | 4 | 4 | 4 | 2 | 1 | na | 1 | na | 1 | 4 | 4 | 4 |
31 | 4 | 4 | 2 | 2 | 4 | 2 | 2 | 1 | 2 | 4 | 4 | 4 |
32 | 4 | 4 | 4 | 4 | 3 | 2 | 3 | 1 | 2 | 4 | 4 | 4 |
33 | 4 | 4 | 4 | 4 | 2 | 2 | 2 | 1 | 2 | 4 | 4 | 4 |
34 | 4 | 4 | 2 | 4 | 3 | 2 | 3 | 1 | 3 | 4 | 4 | 4 |
Prevalence | 100% | 100% | 100% | 100% | 76% | 85% | 82% | 100% | 100% | 100% | ||
Median Detectability | 4 | 4 | 4 | 4 | 2 | 2 | 2 | 4 | 4 | 4 |
Osseous proliferative changes | Bone specimens | Cadaveric specimens |
---|---|---|
Number of specimens | 36 | 10 |
Enthesophytes | ||
supracondylar ridge | 6 | 0 |
superior epicondylar aspect | 0 | 0 |
posterior epicondylar aspect | 0 | 0 |
epicondylar ridge | 13 | 6 |
anterolateral epicondylar face | 5 | 0 |
anterosuperior tubercle | 10 | 0 |
intertubercular tubercle | 6 | 0 |
anteroinferior tubercle | 8 | 0 |
inferior epicondylar aspect | 6 | 0 |
Osteophytes | ||
semilunar area | 26 | 6 |
Cadaveric investigation
Specimen | Supracondylar ridge | Best plane | Superior epicondylar aspect | Best plane | Epicondylar ridge | Best plane | Anterolateral epicondylar face | Best plane | Anterosuperior tubercle | Type | Best plane | Intertubercular sulcus | Best plane | Anteroinferior tubercle | Best plane | Inferior epicondylar aspect | Best plane | Semilunar area | Best plane | Posterior epicondylar aspect | Best plane |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 4 | ax | 4 | sag | 4 | ax | 4 | ax | 4 | 2 | sag | 4 | sag | 4 | sag | 4 | cor | 4 | ax | 4 | cor |
2 | 4 | ax | 4 | sag | 3 | ax | 4 | ax | 3 | 1 | sag | 2 | sag | 1 | na | 3 | cor | 4 | ax | 4 | cor |
3 | 1 | na | 3 | sag | 3 | ax | 4 | ax | 4 | 2 | sag | 4 | sag | 4 | sag | 4 | cor | 4 | ax | 4 | cor |
4 | 4 | ax | 3 | sag | 3 | ax | 4 | ax | 2 | 2 | sag | 2 | sag | 2 | sag | 4 | cor | 4 | ax | 4 | cor |
5 | 3 | ax | 4 | sag | 2 | ax | 4 | ax | 3 | 2 | sag | 3 | sag | 3 | sag | 4 | cor | 4 | ax | 4 | cor |
6 | 2 | ax | 4 | sag | 3 | ax | 4 | ax | 3 | 2 | sag | 4 | sag | 4 | sag | 4 | cor | 4 | ax | 4 | cor |
7 | 3 | ax | 4 | sag | 4 | ax | 4 | ax | 4 | 2 | sag | 4 | sag | 3 | sag | 3 | cor | 4 | ax | 4 | cor |
8 | 3 | ax | 2 | sag | 4 | ax | 4 | ax | 2 | 2 | sag | 2 | sag | 2 | sag | 4 | cor | 4 | ax | 4 | cor |
9 | 4 | ax | 4 | sag | 4 | ax | 4 | ax | 2 | 2 | sag | 2 | sag | 1 | na | 4 | cor | 4 | ax | 4 | cor |
10 | 3 | ax | 4 | sag | 3 | ax | 4 | ax | 1 | na | na | 2 | sag | 3 | sag | 4 | cor | 4 | ax | 4 | cor |
Prevalence/Best plane |
90%
|
ax
|
100%
|
sag
|
100%
|
ax
|
100%
|
ax
|
90%
|
sag
|
100%
|
sag
|
80%
|
sag
|
100%
|
cor
|
100%
|
ax
|
100%
|
cor
| |
Median Detectability |
3
|
4
|
3
|
4
|
3
|
3
|
3
|
4
|
4
|
4
|
Radiologic-anatomic correlation
Attachment/footprint | Osseous landmarks | Prevalence of the landmarks | Best imaging plane |
---|---|---|---|
Medial intermuscular septum | supracondylar ridge | 90% | axial |
Pronator teres tendon | superior epicondylar aspect | 100% | sagittal |
superior margin of anterosuperior tubercle | 90% | sagittal | |
Common flexor tendon | |||
Flexor carpi ulnaris tendon | epicondylar ridge | 100% | axial |
superior margin of anterolateral epicondylar face | 100% | axial | |
Flexor carpi radialis & Palmaris longus tendon | anterolateral epicondylar face | 100% | axial |
medial aspect of anterosuperior tubercle | 90% | sagittal | |
Flexor digitorum superficialis tendon | lateral aspect of anterosuperior tubercle | 90% | sagittal |
intertubercular sulcus (main insertion site) | 100% | sagittal | |
anteroinferior tubercle | 80% | sagittal | |
Ulnar collateral ligament | inferior epicondylar aspect | 100% | coronal |
Joint capsule | inferior epicondylar aspect lateral to ulnar collateral ligament | 100% | coronal |