Ultrasound Use during Anatomy Dissection Lab with Multiple Probes Identifying Ulnar Collateral Ligament from Cadavers and Healthy Volunteers

GODDARD Scott1, Brion BENNINGER1-9. Medical Anatomy Center1, Departments of Medical Anatomical Sciences2, Neuromuscular Medicine3, Family Practice4, Western University of Health Sciences, COMP–Northwest, Lebanon, OR. USA.... [ view full abstract ]

GODDARD Scott1, Brion BENNINGER1-9. Medical Anatomy Center1, Departments of Medical Anatomical Sciences2, Neuromuscular Medicine3, Family Practice4, Western University of Health Sciences, COMP–Northwest, Lebanon, OR. USA. Departments of Orthopaedics5, General Surgery6 and Sports Medicine7, Samaritan Health Services, Corvallis, OR. USA. Departments of Surgery8, Orthopaedics & Rehabilitation9, Oregon Health & Science University, Portland, OR. USA.

INTRODUCTION. The elbow joint participates in prehension of the hand, contributing to the fine motor movements of the upper limb. The elbow has 3 articulations and communicates with the proximal radioulnar joint, in contrast to the wrist, which does not communicate with the distal radioulnar joint. The dominant stabilizing ligament is the ulnar collateral ligament which has 3 sections, of which the anterior band is under the greatest tension and most commonly injured. Chronic, repetitive microtrauma may lead to injury or rupture of the UCL. It would be useful to identify UCL injuries for patients to modify activity before complete ligamental rupture. The objective of this study was to investigate if multiple ultrasound (US) probes could identify the UCL of the elbow in cadavers and volunteers. METHODS. Literature search investigated use of US probes on UCL of cadavers. Four recently deceased unembalmed donors (n=8 sides) were imaged with 5-12 MHz classic linear (CL), finger probe (FP), 18 MHz (18), and 22 MHz (22) probes by three users 3x each station (72 trials per probe x4 probes = 288 trials). 21 volunteers imaged UCL bilaterally on each live control subject with the 18. Users followed a template for probe placement. RESULTS. Literature search revealed no known cadaveric studies using 18 & 22 MHz probes on UCL. Novice users identified UCL in 20/42 examinations. Interestingly, students either correctly identified both sides or none at all, suggesting an anatomical confidence factor. DISCUSSION. All three intermediate users successfully identified UCL using all 4 probes at each of the 8 sides. The different probes were used to produce images of varied qualities. Lower frequency probes revealed less detail than higher frequency probes. This study demonstrated multiple US probes can be used to identify elbow UCL. CONCLUSION. An unstable elbow can be debilitating physically and mentally, especially on the dominant side. This study revealed multiple US probes can identify UCL in cadavers and volunteers, which could improve UCL awareness to prevent debilitating side effects.