Snapping elbow-A guide to diagnosis and treatment

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Diagnostic Imaging

Background:

• Painful snapping elbow syndrome (SE) presents with audible, palpable, and visible snapping.
• Pathology can be either lateral (intra-articular) or medial (extra-articular).
• Early diagnosis and intervention are crucial to prevent ulnar nerve or cartilage damage.

Purpose of the Study:

• To establish practical guidelines for the diagnosis and treatment of painful snapping elbow syndrome (SE).
• To differentiate between medial and lateral snapping elbow pathologies.
• To provide a clear diagnostic and treatment algorithm for SE.

Main Methods:

• A systematic literature search was conducted in PubMed and Scopus for SE-related terms.
• 36 relevant studies were analyzed for patient data, diagnostic methods, pathology, treatments, and outcomes.
• Illustrative patient cases with intra-articular and extra-articular pathology were presented.

Main Results:

• Medial snapping involves ulnar nerve or triceps tendon dislocation, diagnosed by dynamic ultrasonography, treated with open surgery.
• Lateral snapping involves intra-articular pathology (plica, annular ligament, meniscus remnant), diagnosed by arthrography or MRI, treated arthroscopically or surgically.
• Differential diagnoses include loose bodies and postero-lateral instability.

Conclusions:

• Establishing the laterality (medial vs. lateral) of the snapping elbow is the critical first step.
• This laterality dictates the appropriate diagnostic measures and subsequent treatment plan.
• Guidelines were developed to aid clinicians in managing SE effectively.