7b (Elbow) - Answer: 14-year-old female presents with left elbow pain

HISTORY: 

This 14-year-old female presents with left elbow pain.


(QUIZ ANSWER) NOT A FINDING IN THIS CASE: 

Proper radial collateral ligament tear.


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 macrofracture or bony contusion identified. Lateral epicondylar apophysis demonstrates fusion. Widening of the medial apophyseal growth plate, measuring 0.3cm is noted. No evidence of acute osseous injury or fluid intensity in the apophyseal line to suggest recent avulsion injury with mal or nonunion. No osteochondral lesion in the elbow joint. No substantive effusion. 

Proper radial collateral ligament is intact. Low-grade sprain of the lateral ulnar collateral ligament is noted. Anterior and posterior bundles of the ulnar collateral ligament are intact. 

Common flexor and extensor tendons, brachialis, biceps and triceps tendons are intact. 

Neurovascular bundles and musculature are unremarkable. 

 

CONCLUSION

1. Widening of the medial apophyseal growth plate, which measures 0.3cm without evidence of osseous edema or fluid intensity through the apophyseal line, suggestive of chronic avulsion injury with mal or nonunion. 

2. Low-grade sprain of lateral ulnar collateral ligament. 

3. Anterior and posterior bundles of the ulnar collateral ligament are intact. 

4. Mild effusion. No osteochondral lesion.


Discussion
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