Talk:Elbow/Archive 1

A question
what's the reverse side from the elbow called in human anatomy, the pit where it bends in. It should say in this article and link to it I'd think. It seems basic anatomy, but I can't for the life of me think of what it would be called. I don't mean the name of any internal muscle relating to the area. It's distinct from the "armpit", and almost an axillary armpit (no pun intended). 67.5.147.39 (talk) 11:26, 28 February 2008 (UTC)
 * I think what you are referring to is the antecubital fossa. It's not a bad idea to incorporate a link in this article. Preacherdoc (talk) 12:10, 16 May 2008 (UTC)

I call it an "Elpit" myself.--86.143.120.121 (talk) 12:45, 29 August 2011 (UTC)

Carrying Angle
Dear Morbid, You may have mis-read my amendment regarding a sex-bias in the carrying angle. I was referring to reference [3] listed in the Wikipedia page (Steel and Tomlinson- reference 1 in my list below). Steel and Tomlinson state that their study disproves the existence of a sex difference. It is therefore inappropriate to use this reference in Wikipedia as evidence for the existence of a sex difference. Furthermore, the magnitude of the sex difference given in Wikipedia is not consistent with the scientific literature (last 50 years). I suggest that the first paragraph of this section be replaced by following text (or something along these lines). The rephrasing also explains the relationship between the hips and carrying angle, which is not explained clearly in the current entry – see Rojomoke's query below.

Cat4president (talk) 05:40, 7 June 2009 (UTC) Cat4president

When the arm is extended, with the palm facing forward or up, the bones of the upper arm and forearm are not perfectly aligned. The deviation from a straight line occurs in the direction of the thumb, and is referred to as the carrying angle (visible in the right half of the picture, right).

The carrying angle permits the arm to be swung without contacting the hips. Women on average have smaller shoulders and wider hips than men, which may necessitate a greater carrying angle. There is, however, extensive overlap in the carrying angle between individual men and women, and a sex-bias has not been consistently observed in scientific studies [1-3].

The angle is greater in the dominant limb than the non-dominant limb of both sexes [4,5], suggesting that natural forces acting on the elbow modify the carrying angle. Developmental [6], ageing and possibly racial influences add further to the variability of this parameter.


 * 1.	Steel, F.L.D. and J.D.W. Tomlinson, The carrying angle in man. The Journal of Anatomy, 1958. 92: p. 315-317.
 * 2.	Van Roy, P., et al., Arthro-kinematics of the elbow: study of the carrying angle. Ergonomics, 2005. 48(11-14): p. 1645-56.
 * 3.	Zampagni, M.L., et al., Estimating the elbow carrying angle with an electrogoniometer: acquisition of data and reliability of measurements. Orthopedics, 2008. 31(4): p. 370.
 * 4.	Paraskevas, G., et al., Study of the carrying angle of the human elbow joint in full extension: a morphometric analysis. Surg Radiol Anat, 2004. 26(1): p. 19-23.
 * 5.	Yilmaz, E., et al., Variation of carrying angle with age, sex, and special reference to side. Orthopedics, 2005. 28(11): p. 1360-3.
 * 6.	Tukenmez, M., et al., [Measurement of the carrying angle of the elbow in 2,000 children at ages six and fourteen years]. Acta Orthop Traumatol Turc, 2004. 38(4): p. 274-6.

Can someone explain how the larger carrying angle in women is due to their wider pelvic girdle? Rojomoke (talk) 20:59, 11 June 2008 (UTC)

I am removing the comment about the "weinus" because it sites no literature nor does it offer any actual information. The article states that "weinus" has been declared the scientific name for "the ligament." What ligament??? There are numerous ligaments in the elbow but none of them can be substituted as a synonym for the elbow. "Weinus" belongs in the so-called urban dictionary. No anatomist recognizes this term. —Preceding unsigned comment added by 76.20.188.129 (talk) 02:33, 18 July 2008 (UTC)
 * I've been told that the "wenis" (or however it would be spelled) is the name for the rough skin on the outside of the elbow. I came to this article to verify whether that was true or not. 71.231.38.22 (talk) 20:12, 21 November 2008 (UTC)

Sorry about the late reply, no, "wenis/weinus" is not even a word and it is certainly not the name of any anatomic structure!MorbidAnatomy (talk) 21:45, 25 January 2009 (UTC)

The elbow movents
the elbow moves on a pivot —Preceding unsigned comment added by 69.23.200.54 (talk) 23:45, 29 January 2009 (UTC)

Weinus/Weenus/whatever
'''Please stop putting comments in this article about a so-called "wienus" (or however you want to spell it)! There is no such thing as a weinus! It is certainly not another name for the elbow or any part of the elbow. It does not exist. It is not mentioned in the Terminologia Anatomica as issued by the FCAT nor was it ever mentioned in any of the preceding variations of the Nomina Anatomica. Stop putting it in the article! MorbidAnatomy (talk) 01:49, 7 April 2009 (UTC)''' MorbidAnatomy (talk) 01:46, 11 August 2010 (UTC)

Please put comments in this article about a so-called "wienus" (or however you want to spell it)! There is certainly such a thing as a weinus! It is certainly another name for the elbow and any part of the elbow. It does exist. It is greatly mentioned in the Terminologia Anatomica as issued by the FCAT and it was dubiously mentioned in all of the preceding variations of the Nomina Anatomica. Keep putting it in the article! :) <3MorbidAnatomy (talk) 01:49, 7 April 2009 (UTC)
 * .........what? -64.91.131.178 (talk) 23:37, 7 August 2010 (UTC)

very funny. now stop it.MorbidAnatomy (talk) 01:46, 11 August 2010 (UTC)

you guys are both retarded!!!!!

Elbow cap
Why do animals have knee caps, but no elbow cap? Seems the two joints perform similar functions in most animals. Anxietycello (talk) 00:15, 24 June 2009 (UTC)


 * I think the knee cap equivalent in the elbow is the olecranon. Both contribute to stability, protection, and mechanics in their joints.  However, if I recall correctly, the patella is a sesamoid bone ossified within the ligaments tendons that surrounds it, while the olecranon first appears as an ossification centre in the ulna.  --Addingrefs  ( talk | contribs ) 06:58, 24 June 2009 (UTC)

Human chauvinism?
Why is this article focused on human anatomy? Don't non-human animals also have elbows? --causa sui (talk) 20:08, 22 March 2010 (UTC)
 * I agree, I'd like to know the distinction between the elbow and knee, especially when it comes to 4-legged animals.Shhac 21:58, 3 August 2010 (UTC) —Preceding unsigned comment added by Shhac (talk • contribs)

I find the skin on the outside of elbow interesting.
Is there more information on the creases and folds? Thanks. Imagine Reason (talk) 22:47, 30 July 2011 (UTC)

Imaging
The following section was added by RSatUSZ. I moved it here because (1) it needs to be rewritten and (2) is not obviously useful. --Fama Clamosa (talk) 12:35, 24 June 2012 (UTC)

The elbow joint is a complex joint, which consists of three individual joints: humero-radial joint, humero-ulnar joint, and radio-ulnar joint. Numerous ligaments, tendons and muscles are surrounding the joint. The main indications for imaging are acute trauma and chronic overuse injuries. Not only for these indications are CT and MRI used, but also for peripheral nerve compression syndromes and other joint diseases.

Conventional Radiography
The conventional radiography is still a very useful and therefore basic diagnostic tool for the elbow joint. But "cave": The default settings of the X-ray do not match the physiological central joint position. The standard projection in an a.p. beam requires full extension and supination of the arm. Many diseases and injuries can restrict the range of motion, so that the patient’s position could be suboptimal. Consequently could the applicability be lowered. If the joint extension range is restricted due to a traumatic event, a parallel positioning of the forearm to the board can improve the assessment of the humero-radial joint and the radius head at an a.p. projection. The lateral projection is not affected by an extension deficit because it does not require any extension of the arm. But the full supination of the forearm is still necessary. On the basis of an x-Ray it is difficult to quantify any supination deficit.

Especially in this joint, the assessment of soft tissue can point to joint effusions. For example the so-called anterior and posterior fat pad sign. A special projection targeted towards the radius head can improve the judging concerning a fracture. First and foremost common after an inconspicuous standard general view but traumatic joint effusion. Other special projections like the sulcus-ulnaris projection get more and more displaced by the cross sectional imaging.

Important diagnostic reference lines:
 * Anterior humerus line AHL: The AHL intersects the medial third of the capitulum if the lateral position is exact. Consequently are extension and flexion malpositions after supracondylar fractures easier to identify.
 * Radius capitulum axis RCA: The longitudinal axis intersects the shaft of the radius of the capitulum in all projections. But contrary to the popular opinion, the intersection is only in 75% positioned at the center of the capitulum humeri. Slight misalignment shows no radius head deformity. Nevertheless is this reference line valuable for the diagnosis.

Computed Tomography
The CT scans gained of considerable importance in the diagnosis of articular fractures and their therapeutic control. The patient lies in a supine position and the joint should be positioned in moderate flexion over the head. If the arm would be mounted next to the body or on the abdomen, the radiation exposure is higher and the picture is more vulnerable for artifacts. The investigation should be performed on a multidetector CT with minimum thickness, supplemented by adapted sagittal and coronal reformations.

Magnetic Resonance Imaging
Beyond solely the fracture diagnosis, MRI is the cross-section imaging device of choice. This applies to suspected soft tissue changes as well as for chronic overuse injuries and joint blocks. The positioning of the elbow joint is more difficult compared to CT. Surface coils are obligatory required. Ideal storage is possible with elevation of the arm at the isocenter of the magnet. It can occur that a prolonged storage of the arm towards cranial triggers shoulder impingement symptoms. Depending on the available equipment and technology examination with the arm positioned alongside of the body is possible. But that occasionally involves limitations in spectral fat saturation. A storage of the elbow joint on the belly is inappropriate.

Protocol:
 * 1) Coronar T1 SE
 * 2) Coronar water-sensitive sequence (PD FSE FS, STIR)
 * 3) Axial PD FSE FS
 * 4) Facultative also sagittal PDw FSE FS.

As a parameter, a layer of 2mm thickness and a FOV of 80-120mm is recommended. Basically, an investigation of musculo-skeletal problems in an extended matrix (320, 384, 448, 512) should be sought. The goal should be a pixel size of 0.4 mm.

It has to be added that the sagittal plane is at an eventual "postero-lateral rotary instability", for example after dislocation, a good choice to illustrate the centering of the radius head or changes at the olecranon. An injection of contrast agent can be helpful in epicondylitis or rare overuse syndromes.

Husarik et al. examined 60 non-sympomatic volunteers on a 1.5 Tesla MR system. Sequences of choice were T1-weighted spin echo, sagittal T2-weighted fast spin echo, coronar fast spin echo inversion recovery with short time of inversion, transversal intermediate weighted with fat-saturation and coronar three-dimensional fast imaging with steady state precession (FISP) with water stimulus.

The anterior ulnar collateral ligament and the radial collateral ligament were entirely visible in all of the volunteers. The posterior UCL, the lateral UCL and the ligamentum anulare AL were entirely visible on 97%, 85%, respectively, 98%. An increased signal intensity in liquid sensitive sequences has been found at the anterior UCL, posterior UCL, RCL, lateral UCL and AL on 15%, 7%, 2%, 10%, respectively, 2%. 98% showed a plica postero-lateralis but only 33% a posterior plica. 85% showed a pseudo defect of the capitulum.

They concluded that the elbow ligaments and the plica postero-lateralis are throughout visible at non-symptomatic individuals on conventional MR images. Most of the physiological ligaments are thinner than 4mm and most of the physiological plicae are thinner than 3mm.

Ultrasonography
The arthrosonography allows a dynamic study of the soft tissue and bone surfaces. The clinical use is well established, particularly in the pediatrics and rheumatology. In order to verify an intraarticular fluid accumulation the ultrasound is the method of first choice. The evaluation of cartilage is limited. Through power Doppler neovascularizations can be detected sensitively at synovitis or epicondylitis. The examination is carried out by a linear transducer with a frequency from 7.5 up to 13 MHz. The extensioned elbow joint should be depicted ventrally and dorsally, both longitudinally and transversely.

Typical indications for an ultrasonographic examination of the elbow joint: Bony destruction, usure, osteophytes, non-attached joint fragment, chondromatose, osteochondrosis dissecans, avascular bone-cartilage-necrosis, intraarticular volume gain: joint effusion or synovialitis, bursitis, lesion of the distal biceps tendon, dislocation of the caput radii, elbow joint instability, changes of the humeral neck retro torsion angle, gout tophus, rheumatic node, inflammative rheumatic diseases, fractures, foreign bodies, tumor.

GAN
Nominated this article for Good status. TotallyNotEtreo (talk) 14:26, 16 February 2013 (UTC)