Avulsion of the medial epicondyle
7 year old girl presented post minor trauma unwilling to mover her left elbow.
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The capitellum and radial head are demonstrated, as is the start of ossification of the olecranon. However, the medial epicondyle is not demonstrated and it should be present. It has been avulsed. Small elbow joint effusion.
This radiograph demonstrates the importance of knowing the order of ossification at the elbow joint in children.
The presence of olecranon ossification implies that we should have capitellum, radial head, internal epicondyle and trochlear ossification. However, there is no medial (internal) epicondyle.
The diagnosis of a medial epicondyle avulsion was made and there is a small associated effusion.