Traumatic instability of the elbow - anatomy, pathomechanisms and presentation on imaging

Traumatic instability of the elbow is a common problem among patients presenting to emergency departments. As recurrent instability is more common than previously thought and the knowledge of the most frequent underlying causes increases, treatment of elbow instability is becoming increasingly sophisticated. Therefore, it is mandatory for the radiologist to be familiar with the important osseous and soft-tissue stabilisers of the elbow joint and to know the pathomechanisms that lead to a spectrum of joint instability. This article discusses the relevant anatomy in elbow stability with respect to imaging and function, states the mechanisms leading to elbow dislocation and displays the types of traumatic instability of the elbow on radiography, computed tomography, and magnetic resonance imaging. Key Points aEuro cent Expert imaging helps the management of traumatic instability of the elbow aEuro cent The lateral ulnar collateral ligament is the cornerstone for elbow stability aEuro cent Soft-tissue disruption is important in posterolateral rotatory instability aEuro cent Identification of small coronoid process fragments is essential for optimal surgical therapy.