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Annular Ligament Injury
Andrew Sonin, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Abbreviations

            • Radiocapitellar joint (RCJ)
          • Definitions

            • Nursemaid's elbow: Subluxation or dislocation of radial head out of annular ligament sling in young child
            • Adult injury: Annular ligament disrupted as part of larger injury to lateral collateral ligament complex

          IMAGING

          • General Features

            • Radiographic Findings

              • MR Findings

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    PATHOLOGY

                    • General Features

                      CLINICAL ISSUES

                      • Presentation

                        • Demographics

                          • Natural History & Prognosis

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Consider

                                • Image Interpretation Pearls

                                  Selected References

                                  1. Chai JW et al: Ultrasonographic diagnosis of snapping annular ligament in the elbow. Ultrasonography. 34(1):71-3, 2015
                                  2. De Maeseneer M et al: Ultrasound of the elbow with emphasis on detailed assessment of ligaments, tendons, and nerves. Eur J Radiol. 84(4):671-681, 2015
                                  3. Mak S et al: MRI of the annular ligament of the elbow: review of anatomic considerations and pathologic findings in patients with posterolateral elbow instability. AJR Am J Roentgenol. 203(6):1272-9, 2014
                                  4. Browner EA: Nursemaid's elbow (annular ligament displacement). Pediatr Rev. 34(8):366-7; discussion 367, 2013
                                  5. Dohi D: Confirmed specific ultrasonographic findings of pulled elbow. J Pediatr Orthop. 33(8):829-31, 2013
                                  6. Richardson M et al: The usefulness of MRI in atypical pulled/nursemaid's elbow: a case report. J Pediatr Orthop. 32(5):e20-2, 2012
                                  7. Husarik DB et al: Ligaments and plicae of the elbow: normal MR imaging variability in 60 asymptomatic subjects. Radiology. 257(1):185-94, 2010
                                  8. Sanal HT et al: Annular ligament of the elbow: MR arthrography appearance with anatomic and histologic correlation. AJR Am J Roentgenol. 193(2):W122-6, 2009
                                  9. Tan JW et al: Pathology of the annular ligament in paediatric Monteggia fractures. Injury. 39(4):451-5, 2008
                                  10. Galik K et al: The effect of the annular ligament on kinematics of the radial head. J Hand Surg [Am]. 32(8):1218-24, 2007
                                  11. Pearson BV et al: Nursemaid's elbow in a 31-year-old female. Am J Emerg Med. 25(2):222-3, 2007
                                  12. Toupin P et al: Radial head subluxation: how long do children wait in the emergency department before reduction?. CJEM. 9(5):333-7, 2007
                                  13. Bozkurt M et al: The annular ligament: an anatomical study. Am J Sports Med. 33(1):114-8, 2005
                                  14. Choung W et al: Acute annular ligament interposition into the radiocapitellar joint in children (nursemaid's elbow). J Pediatr Orthop. 15(4):454-6, 1995
                                  15. Jones J et al: "Irreducible" nursemaid's elbow. Am J Emerg Med. 13(4):491, 1995
                                  16. Frumkin K: Nursemaid's elbow: a radiographic demonstration. Ann Emerg Med. 14(7):690-3, 1985
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Pathology

                                        • Clinical Issues

                                          TERMINOLOGY

                                          • Abbreviations

                                            • Radiocapitellar joint (RCJ)
                                          • Definitions

                                            • Nursemaid's elbow: Subluxation or dislocation of radial head out of annular ligament sling in young child
                                            • Adult injury: Annular ligament disrupted as part of larger injury to lateral collateral ligament complex

                                          IMAGING

                                          • General Features

                                            • Radiographic Findings

                                              • MR Findings

                                                • Ultrasonographic Findings

                                                  • Imaging Recommendations

                                                    PATHOLOGY

                                                    • General Features

                                                      CLINICAL ISSUES

                                                      • Presentation

                                                        • Demographics

                                                          • Natural History & Prognosis

                                                            • Treatment

                                                              DIAGNOSTIC CHECKLIST

                                                              • Consider

                                                                • Image Interpretation Pearls

                                                                  Selected References

                                                                  1. Chai JW et al: Ultrasonographic diagnosis of snapping annular ligament in the elbow. Ultrasonography. 34(1):71-3, 2015
                                                                  2. De Maeseneer M et al: Ultrasound of the elbow with emphasis on detailed assessment of ligaments, tendons, and nerves. Eur J Radiol. 84(4):671-681, 2015
                                                                  3. Mak S et al: MRI of the annular ligament of the elbow: review of anatomic considerations and pathologic findings in patients with posterolateral elbow instability. AJR Am J Roentgenol. 203(6):1272-9, 2014
                                                                  4. Browner EA: Nursemaid's elbow (annular ligament displacement). Pediatr Rev. 34(8):366-7; discussion 367, 2013
                                                                  5. Dohi D: Confirmed specific ultrasonographic findings of pulled elbow. J Pediatr Orthop. 33(8):829-31, 2013
                                                                  6. Richardson M et al: The usefulness of MRI in atypical pulled/nursemaid's elbow: a case report. J Pediatr Orthop. 32(5):e20-2, 2012
                                                                  7. Husarik DB et al: Ligaments and plicae of the elbow: normal MR imaging variability in 60 asymptomatic subjects. Radiology. 257(1):185-94, 2010
                                                                  8. Sanal HT et al: Annular ligament of the elbow: MR arthrography appearance with anatomic and histologic correlation. AJR Am J Roentgenol. 193(2):W122-6, 2009
                                                                  9. Tan JW et al: Pathology of the annular ligament in paediatric Monteggia fractures. Injury. 39(4):451-5, 2008
                                                                  10. Galik K et al: The effect of the annular ligament on kinematics of the radial head. J Hand Surg [Am]. 32(8):1218-24, 2007
                                                                  11. Pearson BV et al: Nursemaid's elbow in a 31-year-old female. Am J Emerg Med. 25(2):222-3, 2007
                                                                  12. Toupin P et al: Radial head subluxation: how long do children wait in the emergency department before reduction?. CJEM. 9(5):333-7, 2007
                                                                  13. Bozkurt M et al: The annular ligament: an anatomical study. Am J Sports Med. 33(1):114-8, 2005
                                                                  14. Choung W et al: Acute annular ligament interposition into the radiocapitellar joint in children (nursemaid's elbow). J Pediatr Orthop. 15(4):454-6, 1995
                                                                  15. Jones J et al: "Irreducible" nursemaid's elbow. Am J Emerg Med. 13(4):491, 1995
                                                                  16. Frumkin K: Nursemaid's elbow: a radiographic demonstration. Ann Emerg Med. 14(7):690-3, 1985