MR Arthrography of the Elbow: Normal Anatomy and Diagnostic Pitfalls

Purpose Our goal was to determine the normal MR arthrographic appearance of the elbow and to identify the potential diagnostic pitfalls of this technique. Method MRI with intra-articularly administered gadopentetate dimeglumine was performed in seven elbow joints derived from cadavers. Coronal, sagittal, and axial SE T1-weighted images with fat suppression and coronal 3D SPGR images with fat suppression were obtained in each elbow. The elbows were then sectioned. Results This technique allowed depiction of the cartilaginous surfaces of the elbow joint as well as clear delineation of the inner surface of the collateral ligaments. Potential diagnostic pitfalls included fat pads projecting into the joint, synovial folds, and cartilaginous pseudoerosions. Conclusion MR arthrography allows clear delineation of the intraarticular structures of the elbow. However, diagnostic pitfalls exist that increase the difficulty of interpreting MR arthrographic images.