Ossification of the Posterior Capitellum: Description of a New Pathology and Its Radiological Appearance

Overview

Journal Arch Orthop Trauma Surg

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2022 Nov 18

PMID 36399163

Authors

M M Schneider

B Hollinger

A Zimmerer

R Nietschke

H Michaely

F Migliorini

N Maffulli

K J Burkhart

Affiliations

Soon will be listed here.

Abstract

Background: Boxer elbow and handball goalkeeper elbow are causes of impingement characterized by osteophytes formation at the olecranon and coronoid tip as well as their corresponding fossae. Herein, we present another distinct pathology in these patients: the formation of an exostosis at the posterolateral aspect of the elbow.

Methods: Between April 2016 and May 2020, 12 athletes with boxer elbow and handball goalkeeper elbow (mean age of 22 years) suffering from elbow pain were enrolled in the present study. Plain radiography, magnetic resonance imaging (MRI), and computer tomography (CT) scans were used to evaluate the bone conformation of the posterolateral aspect of the elbow. Assessment and staging of the ossification was performed by two independent fellowship-trained elbow surgeons.

Results: Bone marrow edema of the posterior aspect of the elbow at the origin of the anconeus muscle was initially detected in MRI scans. With the progression of the condition, imaging revealed an ossification posterior to the capitellum with bony bridges. In the advanced stage of the disease, the exostoses was unstable as the ossification had no adherence to the posterior capitellum during surgical excision. Plain radiographs are limited in their ability to detect the condition, whereas MRI and CT scans allow to identify a signal enhancement at the posterolateral aspect of the elbow.

Conclusion: In patients without history of elbow trauma, bony irregularities of the posterior aspect of the capitellum may indicate ossification of the posterolateral aspect of the elbow, most likely caused by repetitive hyperextensions.

Citing Articles

Long term functional outcome for the cubital tunnel syndrome after endoscopic assisted release of the ulnar nerve.

Spies C, Cavalcanti Kussmaul A, Heinz M, Bruckner T, Muller L, Unglaub F Arch Orthop Trauma Surg. 2024; 145(1):72.

PMID: 39708061 DOI: 10.1007/s00402-024-05694-8.

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