{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T21:31:04Z","timestamp":1750109464159},"reference-count":48,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,3,25]],"date-time":"2015-03-25T00:00:00Z","timestamp":1427241600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To formally examine the sonographic appearance of the elbow ulnar collateral ligament (UCL) at 30\u00b0 versus 70\u00b0 of elbow flexion in asymptomatic baseball pitchers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A prospective, cross\u2010sectional design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Sports medicine clinic in a tertiary academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Thirty asymptomatic adolescent baseball pitchers 13\u201018 years of age (mean 15.8 years), with at least 3 years of continuous pitching experience and no significant history of elbow pain or injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Static sonographic images of the bilateral UCLs were obtained at 30\u00b0 and 70\u00b0 of elbow flexion by a single experienced examiner. Images were anonymized and randomized into a slide set. Three clinicians with different levels of ultrasound experience reviewed the static 30\u00b0 and 70\u00b0 images for each elbow and chose their preferred image based on UCL conspicuity. The clinicians reviewed a re\u2010randomized slide set 1 week later. A different study co\u2010investigator measured UCL cross\u2010sectional area (CSA) on all images using ultrasound machine electronic calipers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>Preference for the sonographic conspicuity of the UCL at 30\u00b0 versus 70\u00b0 of elbow flexion, and UCL CSA at 30\u00b0 versus 70\u00b0 of flexion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Each clinician demonstrated a significant preference for UCL images obtained at 70\u00b0 of flexion when compared to those obtained at 30\u00b0 (80.3% overall preference for 70\u00b0, <jats:italic>P<\/jats:italic> &lt; .001). There was no statistically significant effect of clinician experience or arm dominance on image preference. The sonographically determined CSA of the UCLs were on average 1.4 mm<jats:sup>2<\/jats:sup> greater at 70\u00b0 than at 30\u00b0 of flexion (<jats:italic>P<\/jats:italic> &lt; .001) when combining dominant and nondominant arms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Static sonographic evaluation of the UCL at 70\u00b0 of elbow flexion should be integrated into UCL imaging protocols. Furthermore, when performing sonographically guided procedures targeting the UCL, clinicians should consider positioning the elbow at &gt;30\u00b0 of flexion to optimize UCL conspicuity and CSA.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.pmrj.2015.03.015","type":"journal-article","created":{"date-parts":[[2015,4,21]],"date-time":"2015-04-21T22:15:48Z","timestamp":1429654548000},"page":"970-977","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Optimal Elbow Angle for Sonographic Visualization of the Ulnar Collateral Ligament"],"prefix":"10.1002","volume":"7","author":[{"given":"Daniel R.","family":"Lueders","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam M.","family":"Pourcho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob L.","family":"Sellon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane L.","family":"Dahm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Smith","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,3,25]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659502300218"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511406220"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200102000-00014"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200103000-00004"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2007.11.012"},{"key":"e_1_2_6_7_2","first-page":"227","article-title":"Diagnosis of an ulnar collateral ligament tear using musculoskeletal ultrasound in a collegiate baseball pitcher: A case report","volume":"5","author":"Wood N.","year":"2010","journal-title":"North Am J Sports Phys Ther"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2009.12.004"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-002-0558-0"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2272020462"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(05)70010-9"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00256-004-0788-4"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2271020288"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.334125059"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513487979"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200204000-00003"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.180.2.1800389"},{"key":"e_1_2_6_18_2","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1016\/j.ejrad.2011.01.117","article-title":"Ultrasound of the elbow: A systematic approach using bony landmarks","volume":"81","author":"De Maeseneer M.","year":"2012","journal-title":"Eur J Radiol"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.157.4.1892039"},{"key":"e_1_2_6_20_2","first-page":"45","article-title":"Utilization of sonography and a stress device in the assessment of partial tears of the ulnar collateral ligament in throwers","volume":"6","author":"Smith W.","year":"2011","journal-title":"Int J Sports Phys Therapy"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/1758-2555-4-11"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1001876"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.7863\/ultra.33.8.1485"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/85.3.257"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2004.05.002"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2014.05.015"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199274010-00009"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-5919(05)70245-3"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513516592"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2001-11333"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.36.6.452"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2008.09.002"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2008.09.001"},{"key":"e_1_2_6_34_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.264055117"},{"key":"e_1_2_6_35_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.05.0528"},{"key":"e_1_2_6_36_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.2375"},{"key":"e_1_2_6_37_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.20728"},{"key":"e_1_2_6_38_2","first-page":"84","article-title":"Functional anatomy of the ligaments of the elbow","author":"Morrey B.F.","year":"1985","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_6_39_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199708000-00015"},{"key":"e_1_2_6_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659402200515"},{"key":"e_1_2_6_41_2","first-page":"203","article-title":"The ulnar collateral ligament of the human elbow joint. Anatomy, function and biomechanics","volume":"175","author":"Fuss F.K.","year":"1991","journal-title":"J Anat"},{"key":"e_1_2_6_42_2","first-page":"42","article-title":"Biomechanics of elbow instability: The role of the medial collateral ligament","author":"Schwab G.H.","year":"1980","journal-title":"Clin Orthop Relat Res"},{"key":"e_1_2_6_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(98)90021-0"},{"key":"e_1_2_6_44_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23715"},{"key":"e_1_2_6_45_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.20486"},{"key":"e_1_2_6_46_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1600-0455.2003.00143.x"},{"key":"e_1_2_6_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2013.07.016"},{"key":"e_1_2_6_48_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658301100506"},{"key":"e_1_2_6_49_2","first-page":"186","article-title":"Experimental elbow instability after transection of the medial collateral ligament","author":"Sojbjerg J.O.","year":"1987","journal-title":"Clin Orthop Relat Res"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.pmrj.2015.03.015","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148215001653?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148215001653?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2015.03.015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T05:37:06Z","timestamp":1694669826000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1016\/j.pmrj.2015.03.015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,3,25]]},"references-count":48,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1016\/j.pmrj.2015.03.015"],"URL":"https:\/\/doi.org\/10.1016\/j.pmrj.2015.03.015","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3,25]]},"assertion":[{"value":"2014-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-03-13","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-03-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}