Medial epicondyle avulsion

Case contributed by Dr Andrew Dixon

Presentation

Dislocated his elbow whilst playing football. The elbow was relocated prior to imaging.

Patient Data

Age: 12 years
Gender: Male
x_ray

There is fracture / avulsion of the internal (medial) epicondyle ossification center which is absent from its normal position. It is displaced inferiorly and located just medial to the coronoid. 

Annotated image

The avulsed and displaced medial epicondyle (M) is marked in red, whereas the normal centers of ossification are marked in white. Note that as the lateral (external) epicondyle is present (L) a medial epicondyle should be easily seen. Knowing this it is then easy to not mistake the displaced fragment for the trochlear center (T) which is also visible. 

Case Discussion

This case highlights the importance of CRITOE, one of the few mnemonics which are crucial to know as it enables you to remember the order of appearance of the elbow ossification centers. 

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