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13b - Answer: 20-year-old male presents with pop sensation of right elbow

Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
Includes DICOM files

HISTORY: 

This 20-year-old male presents with acute pop sensation of right medial elbow while throwing a ball.

(QUIZ ANSWER) PRIMARY FINDING: 

Full-thickness tear distal UCL.

Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.

FINDINGS:

No recent bone injury. Hypertrophy musculature of the proximal forearm and distal upper arm. Small elbow joint effusion. 

Normal signal within the ulnar nerve.

Biceps and brachialis insertions, triceps normal.

Radial collateral ligament, lateral ulnar collateral ligament and common extensor tendon origin with normal signal intensity.

Full-thickness tear distal UCL with stripping along the sublime tubercle and surrounding edema. Retraction minimal. Proximal ligament attachment is intact. Regional hemorrhage or muscle strain involving the medial bundles in the common flexor group.

Focal chondromalacia to suggest a component of abutment between the medial or central radial head and opposing capitellum.

No mass. No body. 

CONCLUSION

1. Full-thickness insertional tear of the UCL at the sublime tubercle. Retraction minimal. Adjacent edema, regional muscle strain, partial tear of the anterior and posterior proximal fibers of the common flexor group. Intramuscular edematous signal extends longitudinally for 32mm. 

2. Component of central humeral articular chondromalacia as relates to sports and chronic microinstability. 

3. No microtrabecular or macrofracture.

LESSON 2, TOPIC 39

Case Challenge: Elbow MRI Cases

Case Challenge

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Content reviewed: October 28, 2021

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