SYNOVIAL PLICA OF THE RADIAL HEAD CAUSING LATERAL ELBOW PAIN

Abstract

Purpose: The aim our study was to establish the existence of a symptomatic humero-radial synovial plica causing lateral elbow pain and the resection of which has improved pain and restored elbow function

Materials & Methods: Our study included 117 consecutive elbow arthroscopies performed by two surgeons for a period of 18 months from January 2002 to July 2003.

All patients were treated non operatively before undergoing arthroscopy. Conservative treatment included rest, activity modification, physiotherapy including ultrasound bracing, NSAIDS and corticoste-riod injection.

Results: Radial head plica were found in 21(18%) out of 117 elbow arthroscopies and were resected using a soft tissue resector. There were 16 men and 5 women in the study group,all of whom were young and active: mean age 38 years (range 24 to 56 years). All patients were scored pre op and post op using the Mayo clinic performance index for the elbow. Of the 21 patients 17(81%) had a post op score 90 or more(excellent) and 5(19%) had a score 75-89(good)

Conclusion: The synovial fold of the humero-radial joint is documented and considered as a meniscus between the two articulation(Duparc f etal 2002). They can also present present as symptoms suggesting intra articular loose bodies(Clarke R.P etal 1998).

In the case of resistant tennis elbow the existence of a radial head synovial plica should be considered. Our study concludes that by resecting the synovial plical fold will relieve the pain and restore the elbow motion.