title: Assessment of medial elbow laxity by gravity stress radiography: comparison of valgus stress radiography with gravity and a Telos stress device.
abstract: BACKGROUND
  Valgus instability was reported to be higher with the elbow in 60° of flexion, rather than in 30° of flexion, although there are no studies using valgus stress radiography by gravity (gravity radiography) with the elbow in 60° of flexion.
  
  
  METHODS
  Fifty-seven patients with medial elbow pain participated. For both elbows, valgus stress radiography by use of a Telos device (Telos radiography) and gravity radiography, with the elbow in 60° of flexion, were performed for the assessment of medial elbow laxity. In both radiographs, the medial elbow joint space (MJS) on the affected side was compared with that on the opposite side, and the increase in the MJS on the affected side was assessed.
  
  
  RESULTS
  For the Telos radiographs, the mean MJS was 4.7 mm on the affected side and 4.0 mm on the opposite side, with the mean increase in the MJS on the affected side being 0.7 mm. For the gravity radiographs, the mean MJS was 5.0 mm on the affected side and 4.2 mm on the opposite side, with the mean increase in the MJS on the affected side being 0.8 mm. There were significant correlations between the Telos and gravity radiographs in the MJS on the affected side, the MJS on the opposite side, and the increase in the MJS on the affected side (respectively, P < .0001). There was also a high level of intraobserver and interobserver reliability for the assessment of the gravity radiographs.
  
  
  CONCLUSIONS
  Gravity radiography is useful for assessment of medial elbow laxity, similar to Telos radiography.
authors.affiliation: Center for Hand, Elbow, and Sports Medicine, Izumi Orthopaedic Hospital, Sendai, Japan. Electronic address: miharada@yoshioka-hp.or.jp.
authors.forename: Mikio
authors.initials: M
authors.lastname: Harada
authors.affiliation: Center for Hand, Elbow, and Sports Medicine, Izumi Orthopaedic Hospital, Sendai, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Takahara
authors.affiliation: Center for Hand, Elbow, and Sports Medicine, Izumi Orthopaedic Hospital, Sendai, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Maruyama
authors.affiliation: Center for Hand, Elbow, and Sports Medicine, Izumi Orthopaedic Hospital, Sendai, Japan.
authors.forename: Tadanobu
authors.initials: T
authors.lastname: Nemoto
authors.affiliation: Center for Hand, Elbow, and Sports Medicine, Izumi Orthopaedic Hospital, Sendai, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koseki
authors.affiliation: Center for Hand, Elbow, and Sports Medicine, Izumi Orthopaedic Hospital, Sendai, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kato
mesh_terms: D000293:Adolescent; D000328:Adult; D018771:Arthralgia / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology; D001265:Athletic Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002648:Child; D004550:Elbow; D004551:Elbow Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006112:Gravitation; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D055815:Young Adult
keywords: Assessment; elbow; gravity; laxity; radiography; valgus stress