48-year-old male with left elbow wound, assess for communication with elbow joint, history of steel pipe falling on arm There is a skin defect along the medial aspect of the elbow with herniation of the subcutaneous fat. Diffuse edema is present within the subcutaneous fat surrounding the elbow. Heterogeneous signal within the subcutaneous fat along the medial aspect of the elbow presumably represents hematoma. There is extensive edema within the distal aspect of the medial and long heads of the triceps muscle, compatible with the stated history of crush injury; the majority if not all of the triceps tendon appears to insert on the olecranon. There is edema within the common flexor tendon and adjacent musculature, but no fluid filled gap to indicate complete rupture. The anterior bundle of the ulnar collateral ligament is intact. The ulnar nerve is slightly medially subluxed from the cubital tunnel. There is a small amount of surrounding fluid as well as mild increased signal intensity within the nerve itself suggesting edema. There is no visible communication of the wound with the elbow joint space. A small amount of fluid is present in the joint without significant effusion. Edema is present within the proximal brachioradialis and extensor carpi radialis longus muscles. Foci of low signal within the extensor carpi radialis longus may represent blood product. There are additional foci of low signal within the subcutaneous fat and musculature along the posterolateral elbow which may likewise reflect blood products. The common extensor tendon and lateral collateral ligament appear intact. There is mild edema within the brachialis muscle, but the tendon of the brachialis and the tendon and muscle of the biceps appear intact. Mild osteoarthritis affects the joint with associated degenerative subchondral signal abnormality.
Soft tissue findings consistent with the stated history of crush injury as described above. No findings to suggest communication of the wound with the elbow joint.