Annular Ligament Recess of the Elbow

recessus ligamenti anularis cubiti

The annular ligament recess is a synovial pocket between the annular ligament and the radial neck, inferior to the radial head. It accommodates synovial fluid and is part of the common elbow synovial cavity, allowing the radial head to rotate during forearm pronation and supination.

Anatomical Data

Boundaries & Contents

Location	Around the neck of the radius, just below the radial head (sacciform recess of the elbow)
Boundaries	Radial neck (inner wall) Deep surface of the annular ligament (outer wall) Lower edge of the annular ligament, where the synovium folds back onto the neck
Contents	Synovial fluid

Biomechanics

Function & Actions

A loose fold of synovium that lets the radial head and neck rotate inside the annular ligament during pronation and supination without tearing the lining.

Clinical Relevance

Clinical Notes

The annular ligament recess fills with fluid in elbow haemarthrosis and synovitis, displacing the lateral fat pad (positive lateral fat pad sign on X-ray). Loose bodies and synovial osteochondromatosis accumulate in this recess. Arthroscopic access via the proximal lateral or direct lateral portal allows assessment and debridement of the annular recess. Radial head fractures may produce bony fragments in this recess.

Pathology

Common Injuries & Conditions

Annular Recess Loose Body

Osteochondral fragment or loose body in the annular ligament recess causing lateral elbow pain and limitation of forearm rotation, removed arthroscopically via the lateral portal.

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