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Musculoskeletal
Diagnosis
Trauma
Elbow
Ligaments
Lateral Ulnar Collateral Ligament Injury
Lateral Ulnar Collateral Ligament Injury
Kirkland W. Davis, MD, FACR; Andrew Sonin, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Lateral ulnar collateral ligament (LUCL), radial collateral ligament (RCL), lateral collateral ligament (LCL) complex
              • Common extensor tendon (CET)

            • Definitions

              • LCL complex = LUCL + RCL + annular ligament
              • Posterolateral rotatory instability of elbow (PLRI) = most common chronic elbow instability; implies some injury to LCL complex
                • LUCL most important for stability

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              CLINICAL ISSUES

                              • Presentation

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    • Image Interpretation Pearls

                                      Selected References

                                      1. Acosta Batlle J et al: The elbow: review of anatomy and common collateral ligament complex pathology using MRI. Insights Imaging. 10(1):43, 2019
                                      2. Conti Mica M et al: Lateral collateral ligament injuries of the elbow - chronic posterolateral rotatory instability (PLRI). EFORT Open Rev. 1(12):461-8, 2016
                                      3. Bonnaig NS et al: Repair and reconstruction of the lateral ulnar collateral ligament. Instr Course Lect. 64:243-6, 2015
                                      4. Anakwenze OA et al: Posterolateral rotatory instability of the elbow. Am J Sports Med. 42(2):485-91, 2014
                                      5. Daluiski A et al: Direct repair for managing acute and chronic lateral ulnar collateral ligament disruptions. J Hand Surg Am. 39(6):1125-9, 2014
                                      6. Kim BS et al: Ligamentous repair of acute lateral collateral ligament rupture of the elbow. J Shoulder Elbow Surg. 22(11):1469-73, 2013
                                      7. Konin GP et al: US of the elbow: indications, technique, normal anatomy, and pathologic conditions. Radiographics. 33(4):E125-47, 2013
                                      8. Rhyou IH et al: Collateral ligament injury in the displaced radial head and neck fracture: correlation with fracture morphology and management strategy to the torn ulnar collateral ligament. J Shoulder Elbow Surg. 22(2):261-7, 2013
                                      9. Wenzke DR: MR imaging of the elbow in the injured athlete. Radiol Clin North Am. 51(2):195-213, 2013
                                      10. Lin KY et al: Functional outcomes of surgical reconstruction for posterolateral rotatory instability of the elbow. Injury. 43(10):1657-61, 2012
                                      11. Rhyou IH et al: Dual reconstruction of the radial collateral ligament and lateral ulnar collateral ligament in posterolateral rotator instability of the elbow. Knee Surg Sports Traumatol Arthrosc. 19(6):1009-12, 2011
                                      12. Husarik DB et al: Ligaments and plicae of the elbow: normal MR imaging variability in 60 asymptomatic subjects. Radiology. 257(1):185-94, 2010
                                      13. Zoner CS et al: Detailed MRI-anatomic study of the lateral epicondyle of the elbow and its tendinous and ligamentous attachments in cadavers. AJR Am J Roentgenol. 195(3):629-36, 2010
                                      14. Stewart B et al: Sonography of the lateral ulnar collateral ligament of the elbow: study of cadavers and healthy volunteers. AJR Am J Roentgenol. 193(6):1615-9, 2009
                                      15. Cheung EV: Chronic lateral elbow instability. Orthop Clin North Am. 39(2):221-8, vi-vii, 2008
                                      16. Tran N et al: Ultrasonography of the elbow. Semin Musculoskelet Radiol. 11(2):105-16, 2007
                                      17. Mehta JA et al: Posterolateral rotatory instability of the elbow. J Am Acad Orthop Surg. 12(6):405-15, 2004
                                      18. Potter HG et al: Posterolateral rotatory instability of the elbow: usefulness of MR imaging in diagnosis. Radiology. 204(1):185-9, 1997
                                      19. O'Driscoll SW: Elbow instability. Hand Clin. 10(3):405-15, 1994
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Imaging

                                          • Top Differential Diagnoses

                                            • Pathology

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Lateral ulnar collateral ligament (LUCL), radial collateral ligament (RCL), lateral collateral ligament (LCL) complex
                                                  • Common extensor tendon (CET)

                                                • Definitions

                                                  • LCL complex = LUCL + RCL + annular ligament
                                                  • Posterolateral rotatory instability of elbow (PLRI) = most common chronic elbow instability; implies some injury to LCL complex
                                                    • LUCL most important for stability

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Ultrasonographic Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Treatment

                                                                      DIAGNOSTIC CHECKLIST

                                                                      • Consider

                                                                        • Image Interpretation Pearls

                                                                          Selected References

                                                                          1. Acosta Batlle J et al: The elbow: review of anatomy and common collateral ligament complex pathology using MRI. Insights Imaging. 10(1):43, 2019
                                                                          2. Conti Mica M et al: Lateral collateral ligament injuries of the elbow - chronic posterolateral rotatory instability (PLRI). EFORT Open Rev. 1(12):461-8, 2016
                                                                          3. Bonnaig NS et al: Repair and reconstruction of the lateral ulnar collateral ligament. Instr Course Lect. 64:243-6, 2015
                                                                          4. Anakwenze OA et al: Posterolateral rotatory instability of the elbow. Am J Sports Med. 42(2):485-91, 2014
                                                                          5. Daluiski A et al: Direct repair for managing acute and chronic lateral ulnar collateral ligament disruptions. J Hand Surg Am. 39(6):1125-9, 2014
                                                                          6. Kim BS et al: Ligamentous repair of acute lateral collateral ligament rupture of the elbow. J Shoulder Elbow Surg. 22(11):1469-73, 2013
                                                                          7. Konin GP et al: US of the elbow: indications, technique, normal anatomy, and pathologic conditions. Radiographics. 33(4):E125-47, 2013
                                                                          8. Rhyou IH et al: Collateral ligament injury in the displaced radial head and neck fracture: correlation with fracture morphology and management strategy to the torn ulnar collateral ligament. J Shoulder Elbow Surg. 22(2):261-7, 2013
                                                                          9. Wenzke DR: MR imaging of the elbow in the injured athlete. Radiol Clin North Am. 51(2):195-213, 2013
                                                                          10. Lin KY et al: Functional outcomes of surgical reconstruction for posterolateral rotatory instability of the elbow. Injury. 43(10):1657-61, 2012
                                                                          11. Rhyou IH et al: Dual reconstruction of the radial collateral ligament and lateral ulnar collateral ligament in posterolateral rotator instability of the elbow. Knee Surg Sports Traumatol Arthrosc. 19(6):1009-12, 2011
                                                                          12. Husarik DB et al: Ligaments and plicae of the elbow: normal MR imaging variability in 60 asymptomatic subjects. Radiology. 257(1):185-94, 2010
                                                                          13. Zoner CS et al: Detailed MRI-anatomic study of the lateral epicondyle of the elbow and its tendinous and ligamentous attachments in cadavers. AJR Am J Roentgenol. 195(3):629-36, 2010
                                                                          14. Stewart B et al: Sonography of the lateral ulnar collateral ligament of the elbow: study of cadavers and healthy volunteers. AJR Am J Roentgenol. 193(6):1615-9, 2009
                                                                          15. Cheung EV: Chronic lateral elbow instability. Orthop Clin North Am. 39(2):221-8, vi-vii, 2008
                                                                          16. Tran N et al: Ultrasonography of the elbow. Semin Musculoskelet Radiol. 11(2):105-16, 2007
                                                                          17. Mehta JA et al: Posterolateral rotatory instability of the elbow. J Am Acad Orthop Surg. 12(6):405-15, 2004
                                                                          18. Potter HG et al: Posterolateral rotatory instability of the elbow: usefulness of MR imaging in diagnosis. Radiology. 204(1):185-9, 1997
                                                                          19. O'Driscoll SW: Elbow instability. Hand Clin. 10(3):405-15, 1994