Page 10 - MSK assignment

10 F. Elahi

Ultrasound Protocol for the Elbow

(Konin et al, 1) Anterior Elbow - Short Axis
2017) Have the patient facing the
sonographer with their arm extended in a
supinated position. Place a pillow below the
joint for full elbow extension. Begin with the
transducer in the transverse plane to
interrogate 5cm above and below the
trochlea-ulna joint (Konin et al., 2017). The
brachioradialis muscle, radial nerve,
capitellum, humerus, trochlea, brachialis
muscle, brachial artery (Br. A), and median
nerve can be noted in this anterior elbow
image. The star is indicating the articular
cartilage. The image for this anatomy is taken
at the supracondylar region (Konin et al., 2017)

2) Distal Biceps Tendon - Long Axis
Patient has their arm extended with maximal
supination. Gently externally rotating the
patient’s hand. The transducer will be in an
oblique longitudinal orientation. To avoid
anisotropy the sonographer must press at the
distal end of the probe (Silvestri et al., 2012). If
(Konin et al.,2013)
the sonographer is having difficulty viewing
the insertion, they can start proximally at the
musculotendinous junction and follow it down.
The biceps tendon can be assessed in both
planes. A dynamic assessment can be done at
the posterior aspect of the proximal forearm.
The patient will be asked to supinate and
pronate their forearms. The sonographer will
look for the disappearance of the distal fibers
with supination. (O’Neill, 2008)