期刊文献+

Snapping elbow-A guide to diagnosis and treatment

Snapping elbow-A guide to diagnosis and treatment
下载PDF
导出
摘要 AIM To develop practical guidelines for diagnosis and treatment of the painful snapping elbow syndrome(SE). METHODS Clinical studies were searched in the databases Pub Med and Scopus for the phrases "SE", "snapping triceps", "snapping ulnar nerve" and "snapping annular ligament". A total of 36 relevant studies were identified. From these we extracted information about number of patients, diagnostic methods, patho-anatomical findings, treatments and outcomes. Practical guidelines for diagnosis and treatment of SE were developed based on analysis of the data. We present two illustrative patient cases-one with intra-articular pathology and one with extra-articular pathology.RESULTS Snapping is audible, palpable and often visible. It has a lateral(intra-articular) or medial(extra-articular) pathology. Snapping over the medial humeral epicondyle is caused by dislocation of the ulnar nerve or a part of the triceps tendon, and is demonstrated by dynamic ultrasonography. Treatment is by open surgery. Lateral snapping over the radial head has an intra-articular pathology: A synovial plica, a torn annular ligament or a meniscus-like remnant from the foetal elbow. Pathology can be visualized by conventional arthrography, magnetic resonance(MR) arthrography, high resolution magnetic resonance imaging(MRI) and arthroscopy, while conventional MRI and radiographs often turn out normal. Treatment is by arthroscopic or eventual open resection. Early surgical intervention is recommended asthe snapping can damage the ulnar nerve(medial) or the intra-articular cartilage(lateral). If medial snapping only occurs during repeated or loaded extension/flexion of the elbow(in sports or work) it may be treated by reduction of these activities. Differential diagnoses are loose bodies(which can be visualized by radiographs) and postero-lateral instability(demonstrates by clinical examination). An algorithm for diagnosis and treatment is suggested.CONCLUSION The primary step is establishment of laterality. From this follows relevant diagnostic measures and treatment as defined in this guideline. AIM To develop practical guidelines for diagnosis and treatment of the painful snapping elbow syndrome(SE). METHODS Clinical studies were searched in the databases Pub Med and Scopus for the phrases "SE", "snapping triceps", "snapping ulnar nerve" and "snapping annular ligament". A total of 36 relevant studies were identified. From these we extracted information about number of patients, diagnostic methods, patho-anatomical findings, treatments and outcomes. Practical guidelines for diagnosis and treatment of SE were developed based on analysis of the data. We present two illustrative patient cases-one with intra-articular pathology and one with extra-articular pathology.RESULTS Snapping is audible, palpable and often visible. It has a lateral(intra-articular) or medial(extra-articular) pathology. Snapping over the medial humeral epicondyle is caused by dislocation of the ulnar nerve or a part of the triceps tendon, and is demonstrated by dynamic ultrasonography. Treatment is by open surgery. Lateral snapping over the radial head has an intra-articular pathology: A synovial plica, a torn annular ligament or a meniscus-like remnant from the foetal elbow. Pathology can be visualized by conventional arthrography, magnetic resonance(MR) arthrography, high resolution magnetic resonance imaging(MRI) and arthroscopy, while conventional MRI and radiographs often turn out normal. Treatment is by arthroscopic or eventual open resection. Early surgical intervention is recommended asthe snapping can damage the ulnar nerve(medial) or the intra-articular cartilage(lateral). If medial snapping only occurs during repeated or loaded extension/flexion of the elbow(in sports or work) it may be treated by reduction of these activities. Differential diagnoses are loose bodies(which can be visualized by radiographs) and postero-lateral instability(demonstrates by clinical examination). An algorithm for diagnosis and treatment is suggested.CONCLUSION The primary step is establishment of laterality. From this follows relevant diagnostic measures and treatment as defined in this guideline.
出处 《World Journal of Orthopedics》 2018年第4期65-71,共7页 世界骨科杂志(英文版)
关键词 ELBOW ARTHROSCOPY SURGERY DIAGNOSIS ULTRASONOGRAPHY Snapping Elbow Arthroscopy Surgery Diagnosis Ultrasonography Snapping
  • 相关文献

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部