[A clinical study on arthrography of the elbow joint (author's transl)]

There are many patients who visit a clinic with some complaints at the elbow joint. In such cases, it is customary to evaluate radiographs in making diagnosis. However, it is often difficult to interpret the X-ray films due to structural complexity of the elbow joint. Although in some cases arthrography is performed, there is neither standard technique nor standard method of projection established, hence the evaluation of the arthrogram is often quite difficult. The purpose of this paper thereby is to study the role of the arthrography of the elbow joint as a diagnostic tool second to plain X-rays. The technique must be simple and interpretation of it must be easy as well. It also should provide much diagnostic informations. The author firstly set a standard procedure of the elbow joint arthrography and a standard series of radiographic projections which suffice the above-mentioned conditions. Secondly, analysis of the procedure was done and the normal arthrograms were shown using cadavers. Thirdly, the author performed this procedure in 250 patients who have various disorders in the elbow joint. Finally, the clinical significance of this procedure as a diagnostic tool to elbow joint diseases was discussed. The results are as follows: 1. One ml of positive contrast medium in a child or 2 ml in an adult was injected through postero-lateral puncture of the radio-brachial joint. Three X-ray films--A-P, lateral, 45 degrees ulnar oblique--were obtained. 2. It was found that the arthrograms taken by this procedure can give informations which cannot be obtained by plain X-rays. 3. This procedure of arthrography is very useful as a diagnostic tool in many occasions i.e. in making correct diagnosis in trauma of children such as fracture, dislocation and ligamentous injury; in finding the existence, the location and the grade of synovitis; in finding the location and the size of a tumor; in finding the precise location of the abnormal shadow at the elbow joint; in deciding the level of the osteotomy in cubitus varus deformity; in evaluating derangement, tardy ulnar palsy and joint instability due to osteochondritis, etc. 4. By the analysis of the arthrograms in 250 patients it was shown that this procedure of arthrography gives significant clinical informations.