The elbow — epicondylitis, distal biceps and collateral ligaments

MRI · USG

First and second year — the floor first, then every step

Common extensor tendinopathy (tennis elbow) and its partial tears, distal biceps rupture with the retraction that decides repair, and the ulnar collateral ligament in the throwing athlete.

Orient first

  • Lateral epicondylitis is a degenerative tendinosis of the ECRB origin.
  • Distal biceps complete rupture: retraction depends on an intact lacertus fibrosus.
  • UCL anterior bundle tears in throwers — the T-sign is a partial undersurface tear.

Acquire the study

  • Axial, coronal and sagittal PD fat-saturated; FABS (flexed, abducted, supinated) view for the biceps.

The manoeuvre

  • Coronal PD fat-saturated: common extensor origin thickening and signal; partial vs full-thickness tear.
  • FABS or sagittal: distal biceps insertion on the radial tuberosity; retraction distance in cm.
  • Coronal: UCL anterior bundle — T-sign, complete tear.
  • Olecranon and capitellum marrow oedema; loose bodies.

What confirms it

  • Tendon or ligament discontinuity with fluid in the gap.

What licenses you to exclude it

  • Normal tendon thickness and signal exclude significant tendinopathy.

The classic misread

  • Magic angle in the common extensor tendon called tendinosis on short-TE sequences.

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