Normal Variants of the Elbow. Olecranon Foramen aka Supratrochlear Foramen.

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Presentation transcript:

Normal Variants of the Elbow

Olecranon Foramen aka Supratrochlear Foramen

Olecranon Foramen

Radioulnar Synostosis usually bilateral may decrease supination or pronation

Supracondylar Process An osseous projection on the anteromedial aspect of the distal humerus Struther’s ligamentStruther’s ligament may extend inferior from this process to the medial epicondyle may cause neurovascular signs or symptoms

Fracture of Supracondylar Process

Ununited Secondary Ossificatio n Center - Medial Epicondyle

Pseudotumor appearance of the Radial Tuberosity

The Wrist

Standard Wrist Series PA Wrist Medial Oblique Wrist Lateral Wrist

PA Wrist Note the overlap between the trapezium and the trapezoid

PA Wrist

Medial Oblique Wrist No overlap between the trapezium and the trapezoid

Lateral Wrist

- the third metacarpal, capitate, lunate and radius should form a straight line

Age of Carpal Appearance Capitate and Hamate:at birth-6 mo Triquetrum:.5 yr-3.5yrs Lunate: yrs Scaphoid:3-9yrs Trapezium:3-9yrs Trapezoid:3-9yrs Pisiform7-13yrs Distal radial epiphysis:.5-2yrs(19) Distal ulnar epiphysis: yrs(18)

Pronator Quadratus Fat Stripe Not visualized or may be displaced following trauma

Accessory Views of the Wrist

PA Wrist with Ulnar Deviation

Carpal Tunnel Projection

Three Arcs of Carpal Alignment Along proximal aspect of proximal row Along distal aspect of proximal row Along proximal aspect of distal row

Intercarpal Distances 2mmThe joint spaces between the carpal bones should not exceed 2mm 2mmthe distal radioulnar joint space should not exceed 2mm

Normal Variants

Carpal Coalition Fusion between the capitate and hamate possibly involving the triquetrum and pisiform

Carpal Coalition

Accessory Ossicle Distal to Ulna Ununited secondary ossification center of the ulnar styloid process. Most likely represents old un-united fracture.

Pie Sign

Negative Ulnar Variance 1-2mm shorterNormally the ulna should be no more than 1-2mm shorter than the radius predisposes lunate to avascular necrosis

Madelung’s Deformity Delayed growth of medial distal radius may result in a posterior subluxation of the ulna and the “bayonette” appearance. Carpal angle >117°.

Madelung’s Deformity

Thank You