INTRODUCTION: Elbow bony impingement is an early sign of the elbow degenerative disease, which limits its mobility due to osteophytes. Despite its rarity, it is important to detect it in the early stages due to the impact on the quality of life, as we decide on surgical treatment early in the progress. Therefore, proper X-ray diagnosis is crucial for elbow bone impingement. It helps us determine the location and extent of degenerative changes, which is crucial in formulating an appropriate treatment plan for such patients.
METHODS: Subjects were included in two groups. The study group included 30 patients with limited elbow mobility, X-ray signs of elbow bony impingement, and in whom the diagnosis of osteophytes was later confirmed during arthroscopic surgery. The control group included 30 patients with extra-articular elbow pathology. On all patients included, mobility, Mayo and Oxford questionnaires, AIa and PIa measurements were performed. The obtained results were compared between the groups. In study group, we compared the results of questionnaires, mobility and X-ray measurements before and after surgery. We found a correlation between the range of motion and the values of the AIa and PIa angles. In order to calculate the reliability of X-ray parameters, we calculated correlation coefficients for individual measurements with 3 evaluators.
RESULTS: In radiological testing, the measurement of AIa and PIa angles is a reliable measurement method with very good to excellent measurement reliability both in repeated measurements of the same evaluator and among evaluators. Also, the reliability of the measurement remains high when comparing the measurements between an experienced and an inexperienced evaluator.
In the basic characteristics (sex, age, involvement of the dominant upper limb), the two groups are comparable. Differences in the sex and age of the patients do not affect the values of the impingement angles. Measuring subjective elbow problems with the Oxford questionnaire does not show significant differences between the groups. Objective measurements of mobility and the Mayo questionnaire show important differences between the groups. There are also statistically significant differences between the groups in the values of AIa and PIa arc. There were statistically significant differences in all measurements in the study group before and after surgery. The results show a statistically significant linear correlation between the range of motion and the corresponding X-ray angle.
CONCLUSION: While subjective measurement methods do not show differences between elbow pathologies, it is possible to determine elbow bony impingement by objective clinical and radiological methods. However, X-ray measurements are essential for accurate identification and thus treatment planning. AIa and PIa angle measurement is a reliable and repeatable method of measurement that significantly correlates with clinical measurements of mobility.
|
