/ ‫التاريخ‬ ‫د‬.

‫أ‬/ ‫الطبيب المعالج‬ /‫االسم‬

Real time Right Elbow joint Ultrasound

According To American Institute Of Ultrasound In Medicine & European Society Of Musculoskeletal Radiology Guidelines
Using static and dynamic scan
Anterior Elbow
Anterior Joint recess
 Longitudinally: normal anterior fat pad filling the coronoid fossa medially and below the
rounded capitellum laterally. no evidence of fluid collection.
 Transversely: characteristic wavy hyperechoic line covered by a thin layer of hypoechoic
articular cartilage, No evidence of cartilage erosions or fluid collections.
Distal Biceps and brachialis tendons
 Normal hyperechoic fibrillar echopattern, extending from myotendinous junction to their
insertions (radial Tuberosity & coronoid process respectively).
Median nerve and Brachial vessels
 Median Nerve: shows Normal fascicular echopattern with characteristic honeycomb
appearance on short-axis view, its cross-sectional area about mm2
 Brachial Vessels: shows normal flow by doppler study. No evidence of thrombosis

Lateral Elbow
Common extensor tendon origin
 shows Normal hyperechoic fibrillar echopattern, extending from
lateral humeral epicondyle to myotendinous junction. No
evidence of Enthesopathy or tendinopathy.
 Examined muscles show Normal hypoechoic muscle fibers
with intervening hyperechoic connective tissue (perimysium)
and characteristic “starry night” appearance on short-axis.
Radio-capitellar joint
 Lateral synovial fringe: normal echogenic filling the superficial
portion of the lateral aspect of the radio capitellar joint.
 Radial Head: Normal hyperechoic echopattern with smooth
surface of bony cortex. No occult fractures.
 Annular Ligament: Normal hyperechoic fibrillar echopattern. No
evidence of ligament tear or bony avulsions.
 Annular recess: Normally not distended.
 posterior interosseous nerve: Normal fascicular echopattern
with characteristic honeycomb appearance, overlying annular
ligament.
Radial collateral ligament
 Normal hyperechoic fibrillar echopattern between the bony attachments.
 No evidence of ligament tear or bony avulsions
Medial Elbow
Common flexor tendon origin
 Normal hyperechoic fibrillar echopattern, extending from
lateral humeral epicondyle to myotendinous junction. No
evidence of Enthesopathy or tendinopathy.
 Examined muscles show Normal hypoechoic muscle fibers with
intervening hyperechoic connective tissue (perimysium) and
characteristic “starry night” appearance on short-axis.
Ulnar collateral ligament
 Normal hyperechoic fibrillar echopattern between the bony
attachments.
 No evidence of ligament tear on dynamic scan.
Posterior Elbow
Distal Triceps tendon
 Normal hyperechoic fibrillar echopattern, extending from myotendinous junction to
its insertion.
 Normal underlying olecranon fossa, No evidence of joint effusion
Cubital tunnel and ulnar nerve
 Normal fascicular echopattern with characteristic honeycomb appearance on
short-axis view, through the cubital tunnel. its cross-sectional area about mm 2
 Good stability of the ulnar nerve within the cubital tunnel on
dynamic scan, No evidence of subluxation.
Olecranon bursa
 Normal non visualized olecranon bursa (Normal one is difficult to be visualized)
 No evidence of Bursitis.
NB Enlargement can be the result of excessive friction, direct trauma, or even infection.

Conclusion
 Normal study.

Dr.Mohamed Soliman, MSc

01112214183