This 16-year-old male presents with an injury to the right elbow during football two weeks prior.
(QUIZ ANSWER) NOT A FINDING IN THIS CASE:
Brachioradialis muscle strain.
Using the diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.
Moderate sized joint effusion. Intraarticular hemorrhagic debris versus small bone fragments are identified. Impaction macrofracture is identified within the capitellum with overlying horizontal plane cartilage defect measuring 3.5mm. Origin intermediate grade tear flexor carpi ulnaris with signal alteration along the proximal ulnar margin of the medial epicondyle to suggest origin avulsion flake bone fragment.
Biceps, triceps, brachioradialis insertions normal. Radial collateral and lateral ulnar collateral ligaments intact. Full thickness tear distal insertion of the UCL at the sublime tubercle, horizontal signal alteration 3.3mm. Swelling of the proximal UCL origin fibers.
Normal signal intensity of the ulnar nerve. Abnormal intermediate T1, T2 hyperintense signal of the FCU muscle at the level of the radial neck.
1. Sequelae of valgus mechanism injury origin - avulsion fracture suggested at the flexor carpi ulnaris (with intermediate grade edematous intrasubstance FCU muscle tear/strain) with flake fragment displaced from the medial epicondyle. Consider CT for such. Distal full thickness UCL ligament tear. Associated macrofracture of the capitellum with surface chondral lesion as above.
2. Intraarticular debris within the joint effusion either hemorrhage or perhaps small cartilage fragments.
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Content reviewed: October 28, 2021