Medial collateral ligament complex of the elbow
The elbow:
review of anatomy and common collateral ligament complex pathology using MRI. Elbow illustration. Medial view (a) demonstrating the medial collateral ligament complex: anterior bundle of the medial collateral ligament (A-MCL), posterior bundle of the medial collateral ligament (P-MCL), and transverse ligament (T-MCL). Lateral view (b) demonstrating the lateral collateral ligament complex: lateral ulnar collateral ligament (LUCL), radial collateral ligament (RCL), and annular ligament (AL)
The elbow:
review of anatomy and common collateral ligament complex pathology using MRI. Consecutive coronal FS PD-weighted MRI (a–c) showing the intact anterior bundle of the medial collateral ligament (A-MCL) complex (white asterisks). It extends from the inferior aspect of the medial epicondyle (ME) to the sublime tubercle of the ulna (white arrowheads). Note the typical striated appearance of the normal proximal A-MCL (white arrows)
The elbow:
review of anatomy and common collateral ligament complex pathology using MRI. Axial T1-weighted MRI (a) and axial FS PD-weighted MRI (b) in two different healthy volunteers showing the intact posterior bundle of the medial collateral ligament complex (white arrows). It extends from the posterior aspect of the medial epicondyle (ME) to the medial aspect of the olecranon process (OP). Cubital tunnel retinaculum (white arrowhead). Ulnar nerve (yellow asterisks). Anconeus epitrochlearis muscle (white asterisk)
The elbow:
review of anatomy and common collateral ligament complex pathology using MRI. Two different patients with chronic elbow pain and medial instability. Coronal FS PD-weighted MRI (a) showing a chronically thickened anterior bundle of the medial collateral ligament (white arrowhead). Coronal FS PD-weighted MRI (b) showing a chronically thickened anterior bundle of the medial collateral ligament (white arrow), and a deformity of the sublime tubercle due to malunion of an old fracture (white asterisk)
The medial (ulnar) collateral ligament (MCL/UCL) complex is a major stabilizer of the elbow joint and resists valgus stress.
Gross anatomy
The MCL complex runs from the humerus to the ulna and is composed of three parts :
- inferior medial epicondyle to the sublime tubercle of the medial coronoid process
- cord-like
- medial epicondyle to the medial olecranon
- thickening of the joint capsule
- runs between the inferior fibers of the anterior and posterior bundles (i.e. medial olecranon to medial coronoid process)
- almost no role in elbow stabilization
Variant anatomy
- accessory ligament (a.k.a. extra band): posterior joint capsule to the transverse ligament (25%)
Radiographic features
MRI
- the anterior band is the only part of the MCL complex which is delineated as a separate structure and is best seen on coronal images
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