gms | German Medical Science

Objectives/Interrogation: MRI findings with clinical symptoms and physical examinations are important to diagnose elbow plica syndrome, but there are no criteria in MRI diagnosis. We compared MRI findings with arthroscopic findings and analyzed the correlation between MRI and arthroscopic findings.

Methods: We studied the patients undergoing arthroscopic surgery of elbow and performed MRI (3.0T, Philips medical systems) at our department from 2010 to 2016. 38 cases were reviewed consisting of 11 men and 27 women in their median age of 49 (16 to 63 years). Among the surgeries conducted for 38 cases, 30 cases were for lateral epicondylitis, 7 cases were for plica syndrome, and 1 case was for loose body.

MRI was observed in the proton density with fat suppression sequences and the length was measured from the joint capsule to the most extruded area. The anterior plica was measured in the sagittal plane and the posterior plica was measured in the sagittal and coronal plane.

The length of the anterior and posterior plica observed on arthroscopy was measured and compared with MRI. The paired t-test was performed with an equivalence test of ± 1 mm for the equivalence limit. The Pearson correlation analysis was used to analyze the correlation between the MRI and the arthroscopic plica findings.

Results and Conclusions: The median value of the anterior plica measured on MRI was 1.5 mm (0-6.8 mm) and the median value of the anterior plica measured on arthroscopy was 1.8 mm (0-7.1 mm). The two measures were statistically equivalent and the correlation coefficient was 0.718, indicating a statistically significant correlatio. (p< 0.001).

The median value of the posterior plica measured on MRI was 3.6 mm (0-6.8 mm) in coronal plane and 5.7 mm (1.9-11.1 mm) in sagittal plane. The median value of the posterior plica measured on arthroscopy was 5.6 mm (1.6-9.7 mm).

The two measures in sagittal MRI and arthroscopy were statistically equivalent, but correlation coefficient was 0.22, indicating no statistically significant correlation (p >0.05). There was a statistically significant difference between the measures in coronal MRI and arthroscopy and the correlation coefficient was -0.05, indicating no statistically significant correlation (p>0.05).

The anterior plica measured by MRI has diagnostic value because it reflect the size observed in the arthroscopy. Relatively, the case of posterior plica is considered to have low diagnostic value due to its low correlation with the arthroscopy.