Little leaguer's elbow

Case contributed by Domenico Nicoletti
Diagnosis certain


A baseball pitcher with persistent medial right elbow pain for weeks and sudden acute exacerbation while throwing. Absence of acute injury by history.

Patient Data

Age: 10 years
Gender: Male

Right and left elbow  


Mild sclerosis of the medial epicondylar physis of the right elbow.

Normal the left elbow.


Coronal fluid-sensitive MR image shows abnormally increased signal intensity within the medial epicondylar physis, with mild physeal widening and adjacent bone marrow edema. Intact the ulnar collateral ligament.

Case Discussion

Little league elbow, seen in throwers aged 8 to 14 years, is an overuse injury to the fusing medial epicondyle apophysis from repetitive throwing in the absence of acute injury. Athletes typically present with medial elbow pain during throwing and sometimes at rest. At times, ulnar nerve irritation causes paresthesias in the ulnar distribution. Comparison radiographs may be necessary to appreciate widening or sclerosis of the medial epicondyle.

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