CASE

Elbow – Avulsion fracture

CASE HISTORY

8-year-old status post fall. Elbow pain.

TECHNICAL FACTORS

Long- and short-axis fat- and water-weighted images were performed. 

KEY IMAGES

This case has no key images.

CASE FINDINGS

  • Moderate-sized elbow effusion. Small focus of chondral edema in the lateral radial neck spares the growth plate. Dominant avulsion fracture of the medial epicondyle. Epicondylar fragment with surrounding hemorrhage is displaced by 3.7mm proximally.
  • Associated swelling origin fibers of the ulnar collateral ligament. Tight adherence along the cartilaginous sublime tubercle. No intercondylar fracture extension. Surrounding soft tissue edema. Origin muscle fibers of the common flexor tendon group demonstrate intrinsic edema and strain. Partial tear proximal fibers at the avulsion fracture site.  
  • Radial collateral ligament and common extensor group intact. Dorsal soft tissue swelling noted. 
  • Normal signal intensity within the anconeus. Nominal edema surrounding the ulnar nerve.
  • Triceps brachialis and biceps tendons intact.

CASE CONCLUSION

  • Open-book type avulsion fracture medial humeral epicondyle (3.7 mmwidening at the craniad margin) with associated regional muscle tear. High-grade partial tear of the proximal UCL fibers. Swelling within the pronator teres and flexor carpi ulnaris common flexor tendon group. Impaction related microtrabecular edema of the radial neck.
  • Normal signal within the radiocapitellar and trochlear olecranon articulation. No direct intra-articular fracture extension. 

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