JSES - 2026-08-28 - Journal Article; Review
Magnetic Resonance Imaging Findings in Simple Elbow Dislocations: A Systematic Review and Meta-Analysis.
Sachinis NP, Bhardwaj V, Scaglia M, Gerace F, Christiane Messina J, Randelli PS, Arrigoni P
Topics
Key Takeaway
After simple elbow dislocation, MRI demonstrates collateral ligament injury in over 90% of cases (MCL 90.6%, LCL 94.3%) and acute osteochondral injury in 57.2%, but prognostic significance of these findings remains unestablished.
Summary Depth
Choose how much analysis to show on this article page.
Summary
This systematic review and meta-analysis quantified MRI injury prevalence after simple elbow dislocation across 8 studies (n=267). Pooled collateral ligament injury rates exceeded 90% for both MCL and LCL, but complete tear rates showed extreme heterogeneity (MCL 53.0%, CI 8.6%-93.1%, I²=86.6%; LCL 59.4%, CI 21.0%-88.9%, I²=69.5%). Osteochondral injury prevalence was 57.2% from only 2 contributing studies, dropping to 37.4% in a reader-choice sensitivity analysis, underscoring radiologist-dependent variability.
Key Limitation
Extreme heterogeneity in complete-tear definitions and radiologist interpretation across studies (I²=86.6% for MCL complete tears) makes the most clinically actionable estimates—those distinguishing partial from complete rupture—unreliable for guiding management thresholds.
Original Abstract
BACKGROUND
Simple elbow dislocations are common injuries; however, the comprehensive magnetic resonance imaging (MRI) injury patterns remain incompletely understood. This systematic review aimed to determine the prevalence and patterns of soft tissue and acute traumatic osteochondral injuries on MRI following simple elbow dislocations.
METHODS
We systematically searched PubMed and Scopus databases from 2000-2025 using a validated search strategy. Studies reporting MRI findings in adult or predominantly adult simple elbow dislocation cohorts were included. Quality assessment used the Newcastle-Ottawa Scale. Pooled prevalence estimates with 95% confidence intervals (CIs) were calculated using random-effects models with logit transformation. GRADE methodology assessed evidence quality.
RESULTS
Eight studies were included, with 267 participants providing baseline MRI data. Seven studies contributed to each analysis of any collateral-ligament injury: medial collateral ligament (MCL) 90.6% (95% CI: 78.6%-96.2%; I 2 =69.0%) and lateral collateral ligament (LCL) 94.3% (95% CI: 86.3%-97.8%; I 2 =35.8%). Only 3 studies contributed compatible complete-tear data: MCL 53.0% (95% CI: 8.6%-93.1%; I 2 =86.6%) and LCL 59.4% (95% CI: 21.0%-88.9%; I 2 =69.5%). Two studies contributed acute traumatic osteochondral data, giving a pooled estimate of 57.2% (95% CI: 42.2%-70.9%; I 2 =59.7%). In a reader-choice sensitivity analysis, replacing the senior radiologist's assessment in the larger study with the junior radiologist's assessment reduced the estimate to 37.4%.
CONCLUSION
MRI abnormalities involving both medial and lateral stabilizing structures are common after simple elbow dislocation, but their prognostic significance remains uncertain. MRI may be considered selectively when post-reduction stability is uncertain or further anatomical definition may influence management; the available evidence does not support routine use after every otherwise stable simple elbow dislocation.
LEVEL OF EVIDENCE
Level IV; Descriptive Epidemiology Study; Systematic Review.