The thickness of plicae on MRI was compared with the normal data in the literature. Elbow symptoms were assessed using a visual analog scale for pain the Mayo Elbow Performance Index and the Disabilities of the Arm, Shoulder and Hand score at a minimum of 2 years after surgery. The diagnosis was based on physical examination and MRI findings. We analyzed 20 patients who received a diagnosis of plica syndrome and underwent arthroscopic débridement between 20. The aims of this study were to characterize the clinical manifestations of this syndrome and to investigate the clinical outcomes of arthroscopic surgery. However, few reports regarding diagnosis based on detailed physical examination and magnetic resonance imaging (MRI) findings are available. Thickened synovial plicae in the radiocapitellar joint have been reported as a cause of lateral elbow pain. Taking this into account, this review is meant to be a starting point for new anatomical and clinical studies. The outcomes of surgical treatments are quite promising although more, higher quality research is needed. Nowadays, RHSPS are quite unknown and previous reports do not seem to agree, leading to misdiagnoses as epicondylitis and making this structure the main cause of some cases of "intractable lateral epicondylitis". The findings on physical examination and imaging diagnosis are multiple and variable. Radiohumeral synovial plica syndrome (RHSPS) may be an isolated condition or it can be associated with other elbow abnormalities. This compression can cause pain and other symptoms such as snapping, catching, mobility restriction, pitching, clicking, locking, blockage, popping and swelling. Traumatism or overuse can turn RHSP into symptomatic structures at any age and can be compressed between the radial and humeral heads during movement. RHSP are remnants of normal embryo development of the articular synovial membrane with different anatomical locations, size and shape. Although its role in elbow injuries and epicondylitis is accepted and its surgical treatment is effective, there is no clear consensus about clinically relevant aspects. Many clinicians are not familiar with radiohumeral synovial plica syndrome since there are not many studies about it and previous reports do not seem to reach a consensus. Radiohumeral synovial plicae syndrome (RHSPS) can cause intractable lateral epicondylitis and can be easily confused with other clinical conditions affecting the elbow. The aim of this article is to review the embryologic development, anatomy and histology, pathophysiologic features, clinical manifestations, physical examination, imaging findings, and treatment of radiohumeral synovial plicae, for their correct clinical interpretation in patients with intractable lateral epicondylitis. Radiohumeral synovial plicae (RHSP) have been studied by different authors in different ways in spite of this, the evidence is poor and the results are controversial and inconclusive even when it comes to referring to this elbow structure. Based on these findings, it appears that osteoarthritis can result in a reduction of the RH plica and affect its morphological appearance.
The posterolateral RH plica can be successfully evaluated using US. The posterolateral RH plica was present in all elbows of the control group (100%) and in 15 (68%) of elbows in the study group (p0.05). The clinical characteristics and radiographic findings of the study group were evaluated. In addition, humeral and radial cartilage thicknesses were also measured. The presence, length, height, thickness, cross sectional area, shape, and echogenicity of the posterolateral RH plica were evaluated in both groups. The control group included a total of 100 healthy elbows (51 subjects) and the study group consisted of 22 elbows (22 patients) with osteoarthritis confirmed clinically and by imaging methods. The aim of this study was to describe the morphological features of posterolateral radiohumeral (RH) plica in asymptomatic subjects and in patients with elbow osteoarthritis using ultrasonography (US).
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