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Sonography of the Medial Collateral Ligament of the Elbow: A Study of Cadavers and Healthy Adult Male Volunteers

Sabrina I. Ward1,2, Sharlene A. Teefey1, George A. Paletta, Jr.3, William D. Middleton1, Charles F. Hildebolt1, David A. Rubin1 and Ken Yamaguchi3

1 Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd., St. Louis, MO 63110.
2 Present address: Department of Radiology, Loma Linda University Medical Center, 11234 Anderson St., Schuman Pavilion, Rm. 2605, Loma Linda, CA 92354.
3 Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO 63110.



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  		Fig. 1A. —Anatomic drawings of ulnar collateral ligament. (Reprinted with permission from [15]) Ulnar collateral ligament is viewed from medial side (A) and volar side (B) of elbow. AB = anterior band, PB = posterior band, Trans = transverse ligament.

 


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  		Fig. 1B. —Anatomic drawings of ulnar collateral ligament. (Reprinted with permission from [15]) Ulnar collateral ligament is viewed from medial side (A) and volar side (B) of elbow. AB = anterior band, PB = posterior band, Trans = transverse ligament.

 


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  		Fig. 2A. —Anterior bundle of medial collateral ligament (AMCL) in cadaver. Longitudinal sonogram shows normal triangle-shaped AMCL. Methylene blue dye (arrow) was injected under sonographic guidance into AMCL. Note surface (arrowheads) of AMCL and its separation from underlying fat. H = humerus, U = ulna.

 


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  		Fig. 2B. —Anterior bundle of medial collateral ligament (AMCL) in cadaver. Photograph of posteromedial dissection of gross specimen shows clamp cradling intact AMCL. Note injected contrast material. HA = humeral attachment, UA = ulnar attachment.

 


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  		Fig. 2C. —Anterior bundle of medial collateral ligament (AMCL) in cadaver. Photograph of gross specimen shows forceps holding split AMCL. Note accurate injection of dye into AMCL (arrowhead).

 


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  		Fig. 3A. —30-year-old male volunteer with healthy anterior bundle of medial collateral ligament (AMCL) of elbow. Subject is positioned and sonographic transducer (arrow) is placed in longitudinal plane of AMCL during examination.

 


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  		Fig. 3B. —30-year-old male volunteer with healthy anterior bundle of medial collateral ligament (AMCL) of elbow. Longitudinal sonogram of AMCL shows short axis (line A) obtained at midpoint of ligament. H = humerus.

 


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  		Fig. 3C. —30-year-old male volunteer with healthy anterior bundle of medial collateral ligament (AMCL) of elbow. Transverse sonogram of AMCL shows measurements of transverse short axis (line B) and thickness or transverse long axis (line C) obtained at approximate midpoint of ligament.

 

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