Elbow

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The elbow joint is a compound synovial articulation that consists of two components: the hu-meroulnar joint and the humeroradial joint. The former is between the humeral trochlea and the ulnar trochlear notch and the latter be-

Humeroradial Joint

Fig. 9.30A, B Osteoarthritis in the manubriosternal joint. A Conventional X-ray tomography of the sternum in a 57-year-old male with chronic sternal pain shows curved linear lucency in the centro-left-lateral portion of the manubriosternal joint (arrow) with the obliteration of the right half (arrowhead). Plain radiography is not useful for the study of this thin and overshadowed joint. B Anterior pinhole scan shows a distinct band-like "hot" area in the centro-left-lateral portion of the joint denoting meta-bolically active arthritis (arrow). Planar bone scintigra-phy cannot distinguish pathological uptake from physiological uptake in this joint

Fig. 9.30A, B Osteoarthritis in the manubriosternal joint. A Conventional X-ray tomography of the sternum in a 57-year-old male with chronic sternal pain shows curved linear lucency in the centro-left-lateral portion of the manubriosternal joint (arrow) with the obliteration of the right half (arrowhead). Plain radiography is not useful for the study of this thin and overshadowed joint. B Anterior pinhole scan shows a distinct band-like "hot" area in the centro-left-lateral portion of the joint denoting meta-bolically active arthritis (arrow). Planar bone scintigra-phy cannot distinguish pathological uptake from physiological uptake in this joint tween the humeral capitulum and the radial head. Osteoarthritis is relatively uncommon in the elbow, and it is generally secondary to trauma. The symptoms include limited motion, pain, and tender soft-tissue swelling.

Radiographic features include joint space narrowing and periarticular eburnation (Fig. 9.32A) and occasional enthesophytosis at the base of the olecranon. As elsewhere, on pinhole scintigraphy the alterations are characterized by the combination of extremely in-

Uptake Humerus Head

Fig. 9.31 Osteoarthritis in the manubriosternal joint. Anterior pinhole scan of the sternum with motion pain in the upper sternum in a 32-yearold woman shows very intense tracer uptake in the central aspect of the manubriosternal joint (arrow). Intense tracer uptake in the sternoclavicular joints (arrowheads) and the first costal cartilages is due to articular motion and ossification, respectively

Fig. 9.31 Osteoarthritis in the manubriosternal joint. Anterior pinhole scan of the sternum with motion pain in the upper sternum in a 32-yearold woman shows very intense tracer uptake in the central aspect of the manubriosternal joint (arrow). Intense tracer uptake in the sternoclavicular joints (arrowheads) and the first costal cartilages is due to articular motion and ossification, respectively

Osteoarthritis Elbow

Fig. 9.32A, B Osteoarthritis in the elbow joint. A Oblique radiograph of the right elbow in a 47-year-old woman shows marked subarticular sclerosis with narrowing of the trochlear joint, producing a semilunar articular deformity (arrows). B Oblique pinhole scan reveals diffusely increased tracer uptake in the periarticular bones with the most intense uptake localized in the trochlear notch, creating the characteristic U-shaped appearance (arrows)

tense tracer uptake localized in the joint that is narrowed and moderately intense uptake in the surrounding periarticular bones. The tro-chlear notch is the site of involvement, producing the characteristic U-shaped uptake (Fig. 9.32B).

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