Elbow MRI:what to expect

Your doctor may recommend an Elbow MRI to look closely at your joint, especially if you have:

• Persistent pain on the outer (lateral) or inner (medial) side of your elbow.
• Sudden, severe pain in the front of the elbow after lifting something heavy.
• Instability or a feeling that the elbow is "giving out," common in throwing athletes.
• Numbness or tingling radiating down to your fingers (signs of nerve compression).
• Locking or catching in the joint, preventing you from fully straightening your arm.

An Elbow MRI helps doctors visualize:

• The common extensor and flexor tendons.
• The ulnar collateral ligament (UCL) and lateral collateral ligament (LCL).
• The distal biceps tendon in the front of the elbow.
• The ulnar, radial, and median nerves.

It is particularly useful for identifying:

• Lateral epicondylitis (Tennis Elbow) and Medial epicondylitis (Golfer's Elbow).
• Tears of the ulnar collateral ligament (common in baseball pitchers, often requiring "Tommy John" surgery).
• Biceps tendon ruptures.
• Loose pieces of bone or cartilage floating in the joint.
• Cubital tunnel syndrome (ulnar nerve entrapment).

Sometimes. For most tendon injuries, an MRI without contrast is sufficient. However, if your doctor suspects a subtle ligament tear or a cartilage defect, they may order an MR Arthrogram, which involves injecting a contrast dye (gadolinium) directly into the elbow joint prior to the scan.

Yes. While symptoms can feel similar, Tennis Elbow involves inflammation and micro-tears in the tendons on the outside (lateral side) of the elbow. Golfer's Elbow involves the tendons on the inside (medial side). The MRI clearly distinguishes which set of tendons is damaged.

There is usually no special preparation. However:

• Remove all jewelry, watches, and clothing containing metal before entering the scan room.
• Inform your doctor or radiographer if you have any implants, such as metal plates or screws from a previous fracture, or an on-body medication pump.
• You can eat, drink, and take medications as usual.

The scan is painless. You will typically lie flat on your back (supine) or flat on your stomach (prone "Superman" position), depending on the equipment and what is most comfortable.

Your elbow will be placed inside a small, dedicated device (a coil) and secured with sandbags or cushions. You’ll hear rhythmic knocking or humming sounds while the scanner takes pictures, and earplugs or headphones will be provided.

You must keep your arm completely still during the scan to avoid blurry images.

The scan usually takes between 20 and 40 minutes, depending on the level of detail required.

If you are positioned on your back with your arm by your side, your head may enter the scanner. If you are claustrophobic, let the Radiographer know. You will have a squeeze ball to communicate with them at any time. You can use a sleep mask, or ask your doctor for a mild sedative prior to your appointment.

After the scan, a Radiologist reviews the images and prepares a report for your doctor. Your doctor will use these findings to discuss treatments, such as physical therapy, bracing, or whether a torn tendon needs surgical repair.

Yes. MRI does not use radiation and is safe for adults and children. If you are pregnant, inform your Radiographer so standard precautions can be taken.

• RadiologyInfo: Musculoskeletal MRI
• ACR Manual on MR Safety
• FDA: MRI benefits and risks

Elbow MRI can assess tendons, ligaments, nerves, bone, and soft tissue in detail, but imaging findings must be matched with the examination and symptoms. Not every painful abnormality needs surgery, and a normal scan does not exclude every cause of pain.