title: The posterior transtriceps approach for intra-articular elbow diagnostics, definitely not forgotten.
abstract: OBJECTIVE
  The elbow is among the most common joints that are aspirated and/or injected. An intra-articular approach should be a convenient and a safe procedure with minimal risk of complications. Several approaches to access the elbow joint have been outlined in the literature, but a comparative study is lacking. This study evaluates the technical feasibility of the lesser-performed posterior transtriceps approach with MR arthrography and compares it to the classic lateral radiocapitellar approach.
  
  
  METHODS
  Using fluoroscopy guidance, MR arthrographies of the elbow were performed in 51 consecutive patients from 2006 to 2011. A classical lateral radiocapitellar approach was performed in 29 and a posterior transtriceps approach in 22 elbows. Studies were retrospectively reviewed with special attention to the extent of extra-articular contrast extravasation. This was a level IV diagnostic study.
  
  
  RESULTS
  Contrast leakage occurred in 12 radiocapitellar approaches, which caused a diagnostic dilemma in one subject. There was only a minimal amount of contrast leakage in five subjects using the transtriceps approach and no diagnostic dilemmas occurred. Results show no significant differences between the approaches. No complications occurred in the posterior transtriceps group and all MR arthrographies were diagnostic.
  
  
  CONCLUSIONS
  The posterior transtriceps approach is a technical feasible procedure, is easy to perform, and avoids a diagnostic dilemma in presumed injuries to the lateral collateral ligament complex. Our results show a tendency of even lesser amount of contrast leakage, further promoting a more widespread usage of the posterior transtriceps approach.
authors.affiliation: Amphia Hospital Breda, Molengracht 21, 4818 CK, Breda, The Netherlands. j.vanwagenberg@mst.nl
authors.forename: Jan-Maarten
authors.initials: JM
authors.lastname: van Wagenberg
authors.forename: Jeroen L
authors.initials: JL
authors.lastname: Turkenburg
authors.forename: Frank T G
authors.initials: FT
authors.lastname: Rahusen
authors.forename: Denise
authors.initials: D
authors.lastname: Eygendaal
mesh_terms: D000328:Adult; D003287:Contrast Media; D004551:Elbow Joint / Q000473:pathology*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000175:diagnosis; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007270:Injections, Intra-Articular; D007592:Joint Diseases / Q000175:diagnosis* / Q000628:therapy*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media