Elbow synovial fold syndrome: MR imaging findings.
OBJECTIVE
We describe the anatomy and MR imaging appearance of elbow plicae.


METHODS
First, five cadavers were evaluated by sectioning and using MR arthrography for evidence of normal or prominent synovial folds to determine the potential origin of elbow plicae. Next, 164 consecutive MR images were evaluated to determine the frequency of the plicae in a clinical population. Last, we retrospectively studied a selected group of eight patients who underwent preoperative MR imaging and in whom enlarged synovial folds were confirmed at surgery.


RESULTS
In the cadavers, the synovial fold appeared to originate from the synovium adjacent to a posterior fat pad. In the clinical population, half the patients showed a synovial fold at the same location; however, most folds were less than or equal to 2 mm in thickness. The eight patients presented clinically with symptoms mimicking an intraarticular body. The synovial fold in symptomatic patients was seen posteriorly just above the olecranon and averaged 3 mm in thickness.


CONCLUSIONS
A synovial fold extending from the posterior fat pad in the elbow is a frequent finding on MR imaging. In a subgroup of patients, plicae, when thickened, may present clinically as a locking elbow. However, overlap exists between the thicknesses of symptomatic and asymptomatic plicae.
Awaya
H
H
Department of Radiology, Thomas Jefferson University Hospital, 132 S. 10th St., 1096 Main Bldg., Philadelphia, PA 19107, USA.
Schweitzer
M E
ME
Feng
S A
SA
Kamishima
T
T
Marone
P J
PJ
Farooki
S
S
Trudell
D J
DJ
Haghighi
P
P
Resnick
D L
DL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D004551:Elbow Joint / Q000473:pathology*; D006801:Humans; D007592:Joint Diseases / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013577:Syndrome; D013583:Synovial Membrane / Q000473:pathology*