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Examination of Pediatric Elbow
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Karthick Rangasamy, Nirmal Raj Gopinathan, Pebam Sudesh
The humeroulnar joint allows flexion and extension movement, and movements of pronation and supination occur at the radio humeral and superior radioulnar joint level. The normal range of motion at the elbow in the flexion–extension plane is considered to be 140° for flexion and 0° extension to −10° for hyperextension, which is assessed in a supinated forearm. The normal range of motion for pronation is 80° and for supination is 90°. Movement of flexion and extension can be demonstrated in sitting as well as standing posture, while hyperextension is best demonstrated in the standing position of a supinated forearm (Figure 6.9).
Biology of Joints
Published in Verna Wright, Eric L. Radin, Mechanics of Human Joints, 2020
The stability of the ankle and humeroulnar joints do not depend solely on their shape. Like other “hinge” joints, these articulations are reinforced on both sides by strong collateral ligaments. These dense bands of collagenous tissue are fixed-length stays between adjacent bones that permit free flexion and extension while preventing significant motion in other axes. In other locations, such as the front of the hip, the back of the knee, and the flexor aspects of interphalangeal joints, broad, strong expansions of the articular capsule serve as ligamentous checks to prevent hyperextension.
Intra-articular and local soft-tissue injections
Published in Harald Breivik, William I Campbell, Michael K Nicholas, Clinical Pain Management, 2008
Michael Shipley, Vanessa Morris
There are three articulations at the elbow: the radio-humeral, humeroulnar, and radioulnar joints. The humeroulnar joint allows flexion and extension, the others pronation and supination. The elbow joint is injected in OA, RA, and crystal arthropathies.
Detection of synovial inflammation in rheumatic diseases using superb microvascular imaging: Comparison with conventional power Doppler imaging
Published in Modern Rheumatology, 2018
Kazuhiro Yokota, Takuma Tsuzuki Wada, Yuji Akiyama, Toshihide Mimura
SMI and cPDI signals were assessed in the joints of both hands (metacarpophalangeal [MCP], proximal interphalangeal [PIP], and interphalangeal [IP] joints), the wrists, elbows, and knees (total 26 joints) using a 9.0 or 18.0 MHz linear transducer (Aplio 300, Toshiba Medical Systems Corporation, Tochigi, Japan). In detail, in the finger joint regions, the 1st to 5th MCP, 2nd to 5th PIP joints, and IP joints were scanned in the longitudinal plane over the dorsal aspect. In the wrist joint regions, the radiocarpal and intercarpal joints, and the distal ulna were scanned in the longitudinal plane over the dorsal aspect. In the elbow joint regions, the humeroradial joints were scanned in the longitudinal plane over the anterior aspect, and humeroulnar joints were scanned in the longitudinal plane over the anterior and lateral aspects. In the knee joint regions, the femorotibial joints were scanned in the longitudinal plane over the anterior, medial and lateral aspects. This study was performed in a daily practice environment. Therefore, using both SMI and cPDI to scan a large number of joints is time-consuming and would unrealistically impair feasibility. Recently, Yoshimi et al. reported that eight selected joints, including the bilateral wrist, knee, and the second and third MCP joints, are sufficient for monitoring the activity of RA in daily practice [10]. Accordingly, we assessed the bilateral wrist, knee, and MCP joints, and we added the PIP, IP, and elbow joints, which are many patients required and relatively easy to assess. SMI and cPDI were performed using a pulse repetition frequency set at 220–234 Hz and 870–966 Hz, respectively. A color-coded SMI, which shows blood flow in a color display, was used. The color gain was automatically set to 40 dB, which adequately suppressed the background color. The synovial SMI and cPDI signals were scored on a semi-quantitative scale of 0 to 3 (0: no synovial blood flow signal); 1: mild (≤3 signals within the synovial hypertrophy); 2: moderate (>3 signals in less than one-half of the synovial hypertrophy); and 3: marked (signals in more than one-half of the synovial hypertrophy) [6]. Each joint/joint region was scored for synovial SMI and cPDI signals on a scale from 0 to 3 (representative imaging of each grade [0 to 3] by SMI is presented in Figure 1). A global index for the total SMI and cPDI scores (the sum of synovial SMI or cPDI signal score obtained for each evaluated joint/joint region; 0 to 114) was calculated for each patient.