Skip to main content
Erschienen in: Der Radiologe 11/2018

20.09.2018 | Leitthema

Normvarianten und Pitfalls rund um den Ellenbogen

verfasst von: Dr. D. Müller, PD Dr. C. Schäffeler

Erschienen in: Die Radiologie | Ausgabe 11/2018

Einloggen, um Zugang zu erhalten

Zusammenfassung

Das Ellenbogengelenk ist aus 3 unterschiedlichen Knochen mit einem Scharnier- und einem Kugelgelenk zusammengesetzt. Mehrere Nerven, Sehnen und Muskeln verlaufen über das Gelenk. Variationen der Anatomie sind auch am Ellenbogen häufig und können Ursache für bestimmte Pathologien sein. Trotz hoher Qualität der modernen Schnittbildgebung bergen einzelne Normalbefunde in der CT oder MRT bei Unkenntnis das Risiko einer Fehlinterpretation. In diesem Artikel werden häufigere aber auch seltene Normvarianten um das Ellenbogengelenk beschrieben. Die klassischen Fallstricke werden aufgezeigt und veranschaulicht sowie einer eventuellen ähnlich anmutenden Pathologie gegenübergestellt.
Literatur
1.
Zurück zum Zitat Jeon IH, Micic ID, Yamamoto N, Morrey BF (2008) Osborne-cotterill lesion: an osseous defect of the capitellum associated with instability of the elbow. AJR Am J Roentgenol 191(3):727–729CrossRef Jeon IH, Micic ID, Yamamoto N, Morrey BF (2008) Osborne-cotterill lesion: an osseous defect of the capitellum associated with instability of the elbow. AJR Am J Roentgenol 191(3):727–729CrossRef
2.
Zurück zum Zitat Osborne G, Cotterill P (1966) Recurrent dislocation of the elbow. J Bone Joint Surg Br 48(2):340–346CrossRef Osborne G, Cotterill P (1966) Recurrent dislocation of the elbow. J Bone Joint Surg Br 48(2):340–346CrossRef
3.
Zurück zum Zitat Rosenberg ZS, Blutreich SI, Schweitzer ME, Zember JS, Fillmore K (2008) MRI features of posterior capitellar impaction injuries. AJR Am J Roentgenol 190(2):435–441CrossRef Rosenberg ZS, Blutreich SI, Schweitzer ME, Zember JS, Fillmore K (2008) MRI features of posterior capitellar impaction injuries. AJR Am J Roentgenol 190(2):435–441CrossRef
4.
Zurück zum Zitat Rosenberg ZS, Beltran J, Cheung YY (1994) Pseudodefect of the capitellum: potential MR imaging pitfall. Radiology 191(3):821–823CrossRef Rosenberg ZS, Beltran J, Cheung YY (1994) Pseudodefect of the capitellum: potential MR imaging pitfall. Radiology 191(3):821–823CrossRef
5.
Zurück zum Zitat Rosenberg ZS, Bencardino J, Beltran J (1997) MR imaging of normal variants and interpretation pitfalls of the elbow. Magn Reson Imaging Clin N Am 5(3):481–499PubMed Rosenberg ZS, Bencardino J, Beltran J (1997) MR imaging of normal variants and interpretation pitfalls of the elbow. Magn Reson Imaging Clin N Am 5(3):481–499PubMed
6.
Zurück zum Zitat Timmerman LA, Andrews JR (1994) Undersurface tear of the ulnar collateral ligament in baseball players. A newly recognized lesion. Am J Sports Med 22(1):33–36CrossRef Timmerman LA, Andrews JR (1994) Undersurface tear of the ulnar collateral ligament in baseball players. A newly recognized lesion. Am J Sports Med 22(1):33–36CrossRef
7.
Zurück zum Zitat Munshi M, Pretterklieber ML, Chung CB, Haghighi P, Cho JH, Trudell DJ et al (2004) Anterior bundle of ulnar collateral ligament: evaluation of anatomic relationships by using MR imaging, MR arthrography, and gross anatomic and histologic analysis. Radiology 231(3):797–803CrossRef Munshi M, Pretterklieber ML, Chung CB, Haghighi P, Cho JH, Trudell DJ et al (2004) Anterior bundle of ulnar collateral ligament: evaluation of anatomic relationships by using MR imaging, MR arthrography, and gross anatomic and histologic analysis. Radiology 231(3):797–803CrossRef
8.
Zurück zum Zitat Dellon AL (1986) Musculotendinous variations about the medial humeral epicondyle. J Hand Surg Br 11(2):175–181PubMed Dellon AL (1986) Musculotendinous variations about the medial humeral epicondyle. J Hand Surg Br 11(2):175–181PubMed
9.
Zurück zum Zitat Masear VR, Hill JJ Jr., Cohen SM (1988) Ulnar compression neuropathy secondary to the anconeus epitrochlearis muscle. J Hand Surg Am 13(5):720–724CrossRef Masear VR, Hill JJ Jr., Cohen SM (1988) Ulnar compression neuropathy secondary to the anconeus epitrochlearis muscle. J Hand Surg Am 13(5):720–724CrossRef
10.
Zurück zum Zitat O’Driscoll SW, Horii E, Carmichael SW, Morrey BF (1991) The cubital tunnel and ulnar neuropathy. J Bone Joint Surg Br 73(4):613–617CrossRef O’Driscoll SW, Horii E, Carmichael SW, Morrey BF (1991) The cubital tunnel and ulnar neuropathy. J Bone Joint Surg Br 73(4):613–617CrossRef
11.
Zurück zum Zitat Jeon IH, Fairbairn KJ, Neumann L, Wallace WA (2005) MR imaging of edematous anconeus epitrochlearis: another cause of medial elbow pain? Skeletal Radiol 34(2):103–107CrossRef Jeon IH, Fairbairn KJ, Neumann L, Wallace WA (2005) MR imaging of edematous anconeus epitrochlearis: another cause of medial elbow pain? Skeletal Radiol 34(2):103–107CrossRef
12.
Zurück zum Zitat Oh CS, Chung IH, Koh KS (2000) Anatomical study of the accessory head of the flexor pollicis longus and the anterior interosseous nerve in Asians. Clin Anat 13(6):434–438CrossRef Oh CS, Chung IH, Koh KS (2000) Anatomical study of the accessory head of the flexor pollicis longus and the anterior interosseous nerve in Asians. Clin Anat 13(6):434–438CrossRef
13.
Zurück zum Zitat Mahakkanukrauh P, Surin P, Ongkana N, Sethadavit M, Vaidhayakarn P (2004) Prevalence of accessory head of flexor pollicis longus muscle and its relation to anterior interosseous nerve in Thai population. Clin Anat 17(8):631–635CrossRef Mahakkanukrauh P, Surin P, Ongkana N, Sethadavit M, Vaidhayakarn P (2004) Prevalence of accessory head of flexor pollicis longus muscle and its relation to anterior interosseous nerve in Thai population. Clin Anat 17(8):631–635CrossRef
14.
Zurück zum Zitat al-Qattan MM (1996) Gantzer’s muscle. An anatomical study of the accessory head of the flexor pollicis longus muscle. J Hand Surg Br 21(2):269–270CrossRef al-Qattan MM (1996) Gantzer’s muscle. An anatomical study of the accessory head of the flexor pollicis longus muscle. J Hand Surg Br 21(2):269–270CrossRef
15.
Zurück zum Zitat Girdany BR, Golden R (1952) Centers of ossification of the skeleton. Am J Roentgenol Radium Ther Nucl Med 68(6):922–924PubMed Girdany BR, Golden R (1952) Centers of ossification of the skeleton. Am J Roentgenol Radium Ther Nucl Med 68(6):922–924PubMed
16.
Zurück zum Zitat Emery KH, Zingula SN, Anton CG, Salisbury SR, Tamai J (2016) Pediatric elbow fractures: a new angle on an old topic. Pediatr Radiol 46(1):61–66CrossRef Emery KH, Zingula SN, Anton CG, Salisbury SR, Tamai J (2016) Pediatric elbow fractures: a new angle on an old topic. Pediatr Radiol 46(1):61–66CrossRef
17.
Zurück zum Zitat Chen Y, Tam HH (2012) Ossification centres in a radiograph of a child’s elbow. BMJ 345:e6965CrossRef Chen Y, Tam HH (2012) Ossification centres in a radiograph of a child’s elbow. BMJ 345:e6965CrossRef
18.
Zurück zum Zitat DeFroda SF, Hansen H, Gil JA, Hawari AH, Cruz AI Jr. (2017) Radiographic evaluation of common pediatric elbow injuries. Orthop Rev (pavia) 9(1):7030CrossRef DeFroda SF, Hansen H, Gil JA, Hawari AH, Cruz AI Jr. (2017) Radiographic evaluation of common pediatric elbow injuries. Orthop Rev (pavia) 9(1):7030CrossRef
19.
Zurück zum Zitat Patel B, Reed M, Patel S (2009) Gender-specific pattern differences of the ossification centers in the pediatric elbow. Pediatr Radiol 39(3):226–231CrossRef Patel B, Reed M, Patel S (2009) Gender-specific pattern differences of the ossification centers in the pediatric elbow. Pediatr Radiol 39(3):226–231CrossRef
20.
Zurück zum Zitat Chapman VM, Nimkin K, Jaramillo D (2004) The pre-ossification center: normal CT and MRI findings in the trochlea. Skeletal Radiol 33(12):725–727CrossRef Chapman VM, Nimkin K, Jaramillo D (2004) The pre-ossification center: normal CT and MRI findings in the trochlea. Skeletal Radiol 33(12):725–727CrossRef
21.
Zurück zum Zitat Natsis K (2008) Supracondylar process of the humerus: study on 375 Caucasian subjects in Cologne, Germany. Clin Anat 21(2):138–141CrossRef Natsis K (2008) Supracondylar process of the humerus: study on 375 Caucasian subjects in Cologne, Germany. Clin Anat 21(2):138–141CrossRef
22.
Zurück zum Zitat Andreisek G, Crook DW, Burg D, Marincek B, Weishaupt D (2006) Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics 26(5):1267–1287CrossRef Andreisek G, Crook DW, Burg D, Marincek B, Weishaupt D (2006) Peripheral neuropathies of the median, radial, and ulnar nerves: MR imaging features. Radiographics 26(5):1267–1287CrossRef
23.
Zurück zum Zitat Pecina M, Boric I, Anticevic D (2002) Intraoperatively proven anomalous Struthers’ ligament diagnosed by MRI. Skeletal Radiol 31(9):532–535CrossRef Pecina M, Boric I, Anticevic D (2002) Intraoperatively proven anomalous Struthers’ ligament diagnosed by MRI. Skeletal Radiol 31(9):532–535CrossRef
24.
Zurück zum Zitat Tillmann B (1978) A contribution to the functional morphology of articular surfaces. Norm Pathol Anat (stuttg) 34:1–50 Tillmann B (1978) A contribution to the functional morphology of articular surfaces. Norm Pathol Anat (stuttg) 34:1–50
25.
Zurück zum Zitat Fowler KA, Chung CB (2006) Normal MR imaging anatomy of the elbow. Radiol Clin North Am 44(4):553–567CrossRef Fowler KA, Chung CB (2006) Normal MR imaging anatomy of the elbow. Radiol Clin North Am 44(4):553–567CrossRef
26.
Zurück zum Zitat Rosenberg ZS, Bencardino J, Beltran J (1998) MRI of normal variants and interpretation pitfalls of the elbow. Semin Musculoskelet Radiol 2(2):141–155CrossRef Rosenberg ZS, Bencardino J, Beltran J (1998) MRI of normal variants and interpretation pitfalls of the elbow. Semin Musculoskelet Radiol 2(2):141–155CrossRef
27.
Zurück zum Zitat Rosenberg ZS, Beltran J, Cheung Y, Broker M (1995) MR imaging of the elbow: normal variant and potential diagnostic pitfalls of the trochlear groove and cubital tunnel. AJR Am J Roentgenol 164(2):415–418CrossRef Rosenberg ZS, Beltran J, Cheung Y, Broker M (1995) MR imaging of the elbow: normal variant and potential diagnostic pitfalls of the trochlear groove and cubital tunnel. AJR Am J Roentgenol 164(2):415–418CrossRef
28.
Zurück zum Zitat Obermann WR, Loose HW (1983) The os supratrochleare dorsale: a normal variant that may cause symptoms. AJR Am J Roentgenol 141(1):123–127CrossRef Obermann WR, Loose HW (1983) The os supratrochleare dorsale: a normal variant that may cause symptoms. AJR Am J Roentgenol 141(1):123–127CrossRef
29.
Zurück zum Zitat Quinn SF, Haberman JJ, Fitzgerald SW, Traughber PD, Belkin RI, Murray WT (1994) Evaluation of loose bodies in the elbow with MR imaging. J Magn Reson Imaging 4(2):169–172CrossRef Quinn SF, Haberman JJ, Fitzgerald SW, Traughber PD, Belkin RI, Murray WT (1994) Evaluation of loose bodies in the elbow with MR imaging. J Magn Reson Imaging 4(2):169–172CrossRef
30.
Zurück zum Zitat Duparc F, Putz R, Michot C, Muller JM, Freger P (2002) The synovial fold of the humeroradial joint: anatomical and histological features, and clinical relevance in lateral epicondylalgia of the elbow. Surg Radiol Anat 24(5):302–307CrossRef Duparc F, Putz R, Michot C, Muller JM, Freger P (2002) The synovial fold of the humeroradial joint: anatomical and histological features, and clinical relevance in lateral epicondylalgia of the elbow. Surg Radiol Anat 24(5):302–307CrossRef
31.
Zurück zum Zitat Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M (2010) Ligaments and plicae of the elbow: normal MR imaging variability in 60 asymptomatic subjects. Radiology 257(1):185–194CrossRef Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M (2010) Ligaments and plicae of the elbow: normal MR imaging variability in 60 asymptomatic subjects. Radiology 257(1):185–194CrossRef
32.
Zurück zum Zitat Awaya H, Schweitzer ME, Feng SA, Kamishima T, Marone PJ, Farooki S et al (2001) Elbow synovial fold syndrome: MR imaging findings. AJR Am J Roentgenol 177(6):1377–1381CrossRef Awaya H, Schweitzer ME, Feng SA, Kamishima T, Marone PJ, Farooki S et al (2001) Elbow synovial fold syndrome: MR imaging findings. AJR Am J Roentgenol 177(6):1377–1381CrossRef
33.
Zurück zum Zitat Stein JM, Cook TS, Simonson S, Kim W (2011) Normal and variant anatomy of the elbow on magnetic resonance imaging. Magn Reson Imaging Clin N Am 19(3):609–619CrossRef Stein JM, Cook TS, Simonson S, Kim W (2011) Normal and variant anatomy of the elbow on magnetic resonance imaging. Magn Reson Imaging Clin N Am 19(3):609–619CrossRef
34.
Zurück zum Zitat Zeiss J, Saddemi SR, Ebraheim NA (1992) MR imaging of the quadriceps tendon: normal layered configuration and its importance in cases of tendon rupture. AJR Am J Roentgenol 159(5):1031–1034CrossRef Zeiss J, Saddemi SR, Ebraheim NA (1992) MR imaging of the quadriceps tendon: normal layered configuration and its importance in cases of tendon rupture. AJR Am J Roentgenol 159(5):1031–1034CrossRef
35.
Zurück zum Zitat Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M (2009) Elbow nerves: MR findings in 60 asymptomatic subjects—normal anatomy, variants, and pitfalls. Radiology 252(1):148–156CrossRef Husarik DB, Saupe N, Pfirrmann CW, Jost B, Hodler J, Zanetti M (2009) Elbow nerves: MR findings in 60 asymptomatic subjects—normal anatomy, variants, and pitfalls. Radiology 252(1):148–156CrossRef
36.
Zurück zum Zitat Baumer P, Dombert T, Staub F, Kaestel T, Bartsch AJ, Heiland S et al (2011) Ulnar neuropathy at the elbow: MR neurography—nerve T2 signal increase and caliber. Radiology 260(1):199–206CrossRef Baumer P, Dombert T, Staub F, Kaestel T, Bartsch AJ, Heiland S et al (2011) Ulnar neuropathy at the elbow: MR neurography—nerve T2 signal increase and caliber. Radiology 260(1):199–206CrossRef
Metadaten
Titel
Normvarianten und Pitfalls rund um den Ellenbogen
verfasst von
Dr. D. Müller
PD Dr. C. Schäffeler
Publikationsdatum
20.09.2018
Verlag
Springer Medizin
Erschienen in
Die Radiologie / Ausgabe 11/2018
Print ISSN: 2731-7048
Elektronische ISSN: 2731-7056
DOI
https://doi.org/10.1007/s00117-018-0457-6

Weitere Artikel der Ausgabe 11/2018

Der Radiologe 11/2018 Zur Ausgabe

Mitteilungen des Berufsverbandes der Deutschen Radiologen

Mitteilungen des Berufsverbandes der Deutschen Radiologen

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.