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Imaging Quiz: A Swollen, Painful Elbow

Jane T. Servi, MD, Robert J. Johnson, MD

THE PHYSICIAN AND SPORTSMEDICINE - VOL 24 - NO. 9 - SEPTEMBER 96


A 26-year-old woman was involved in a physical confrontation in which her right arm was forcefully internally rotated behind her back. She experienced immediate pain. The following morning she awoke with a swollen, painful elbow that had limited range of motion.

The patient denied any previous elbow injury or trauma. Physical examination revealed an elbow effusion, elbow flexion limited to 90°, and elbow extension limited to 45°. No gross bony abnormality was noted. The medial and lateral epicondyles and periolecranon area were tender to palpation. Ligament assessment was prohibited by pain. Anteroposterior and lateral radiographs were obtained. A lateral radiograph of the patient's right elbow is shown in figure 1.

What's your diagnosis, and what treatment would you recommend?

Dr Servi is a former sports medicine fellow and Dr Johnson is director of Primary Care Sports Medicine at Hennepin County Medical Center in Minneapolis. Dr Servi is a member and Dr Johnson is a fellow of the American College of Sports Medicine. Dr Johnson is an editorial board member of The Physician and Sportsmedicine. Address correspondence to Robert J. Johnson, MD, Hennepin County Medical Center, Family Medical Center, 5 W Lake St, Minneapolis, MN 55408.


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