Synovial Fold Syndrome

One of the most difficult diagnoses in the elbow pain is synovial fold syndrome. These folds of synovial membrane are remnants of embryological synovial tissue in the elbow joint. With extension of the elbow patient feels pain at the back of the elbow. The baseball player usually feels the pain at the end of the pitch cycle during the release phase. The MR imaging is diagnostic. It shows the synovial fold in symptomatic patients posteriorly just above the olecranon or between the humerus and the radius in the radiocapitellar joint This tissue averages 3 mm in thickness. The presence of synovial fold is not always symptomatic, but if symptoms arise, cortisone shots could be tried for relief. If the symptoms are bothersome and interfere with the game, we recommend arthroscopic surgery. In elbow arthroscopy, we can examine the entire elbow joint directly with 3.5 mm scopes and visualize the extent of the synovial fold. We remove this tissue with shavers. We release patients to activity and sports as soon as the incisions heal.

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