CURRENT CONCEPTS IN ADULTS UPPER EXTREMITY FRACTURES

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IMAGING AND DIAGNOSTIC TESTS IN ELBOW REGION FRACTURES

Kubilay Uğurcan Ceritoğlu1 Onur Yılmaz2

1Çanakkale Onsekiz Mart University, Faculty of Medicine, Department of Orthopedics and Traumatology, Çanakkale, Türkiye
2Çanakkale Mehmet Akif Ersoy State Hospital, Department of Orthopedics and Traumatology, Çanakkale, Türkiye

Ceritoğlu KU, Yılmaz O. Imaging and Diagnostic Tests in Elbow Region Fractures. In: Tiftikçi U, Erdoğan E, Ergün C, Güneş Z, editors. Current Concepts in Adults Upper Extremity Fractures. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.159-166.

ABSTRACT

Elbow fractures are common injuries that often pose significant diagnostic and therapeutic challenges due to their complex nature. These injuries, prevalent among both adults and children, may result from various trauma mechanisms such as falls, sports-related accidents, or high-energy impacts. Early and accurate diagnosis is essential to prevent complications like stiffness, chronic pain, instability, or deformity.

The diagnostic process begins with a comprehensive patient history and physical examination. Key clinical signs, such as limited range of motion, point tenderness, swelling, and the presence of ecchymosis, can indicate potential fractures or ligament injuries. Tests like the elbow extension test and stress tests for varus/valgus instability play a pivotal role in identifying subtle injuries that may not be immediately apparent.

Imaging serves as a cornerstone in the diagnosis and management of elbow fractures. Radiography is typically the first-line imaging modality due to its widespread availability, cost-effectiveness, and high sensitivity for detecting bony injuries. Radiographs must be taken with the ideal technique in order to make the correct diagnosis. However, radiographs can be limited in their ability to detect non-displaced fractures or associated soft tissue injuries, necessitating advanced modalities such as computed tomography (CT) or magnetic resonance imaging (MRI). CT provides detailed visualization of complex fractures, while MRI excels in assessing ligament, tendon, and cartilage injuries. Additionally, ultrasound is emerging as a valuable, non-invasive, and radiation-free tool, particularly in pediatric populations where minimizing radiation exposure is a priority.

This chapter provides a comprehensive review of diagnostic strategies for elbow fractures, detailing the utility of various imaging modalities and clinical tests. By integrating findings from physical examination with advanced imaging techniques, clinicians can achieve greater diagnostic accuracy, optimize treatment planning, and improve patient outcomes. The development of new imaging technologies holds promise for further enhancing the diagnostic process while reducing radiation exposure and improving accessibility.

Keywords: Elbow injuries; Elbow fractures; Elbow; Radiography; Tomography; Ultrasonography

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