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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 5, 684-686.
doi: 10.1302/0301-620X.87B5.14851  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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The detection of loose bodies in the elbow

THE VALUE OF MRI AND CT ARTHROGRAPHY

J. H. Dubberley, MD, FRCSC, Orthopaedic Surgeon1; K. J. Faber, MD, FRCSC, Orthopaedic Surgeon2; S. D. Patterson, MD, FRCSC, Orthopaedic Surgeon3; G. Garvin, MD, FRCP, Radiologist2; J. Bennett, MD, FRCP, Radiologist2; W. Romano, MD, FRCP, Radiologist2; J. C. MacDermid, PhD, Researcher2; and G. J. W. King, MD, FRCSC, Orthopaedic Surgeon2

1 St. Boniface General Hospital, University of Manitoba, Z3045-409 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada
2 The Hand and Upper Limb Centre, St. Joseph’s Health Centre, University of Western Ontario, 268 Grosvenor Street, London, Ontario N6A 4L6, Canada
3 Central Florida Orthopaedic Surgery Associates, PL, 2000 East Edgewood Drive, Lakeland, Florida 33803-3639, USA.

Correspondence should be sent to Dr G. J. W. King; e-mail: gking{at}uwo.ca

Our aim was to determine the clinical value of MRI and CT arthrography in predicting the presence of loose bodies in the elbow.

A series of 26 patients with mechanical symptoms in the elbow had plain radiography, MRI and CT arthrography, followed by routine arthroscopy of the elbow. The location and number of loose bodies determined by MRI and CT arthrography were recorded. Pre-operative plain radiography, MRI and CT arthrography were compared with arthroscopy.

Both MRI and CT arthrography had excellent sensitivity (92% to 100%) but low to moderate specificity (15% to 77%) in identifying posteriorly-based loose bodies. Neither MRI nor CT arthrography was consistently sensitive (46% to 91%) or specific (13% to 73%) in predicting the presence or absence of loose bodies anteriorly. The overall sensitivity for the detection of loose bodies in either compartment was 88% to 100% and the specificity 20% to 70%. Pre-operative radiography had a similar sensitivity and specificity of 84% and 71%, respectively.

Our results suggest that neither CT arthrography nor MRI is reliable or accurate enough to be any more effective than plain radiography alone in patients presenting with mechanical symptoms in the elbow.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General