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Stress Injury of the Proximal Ulna in Professional Baseball Players

Mark S. Schickendantz, MD^*,, Charles P. Ho, MD, PhD and Jason Koh, MD

^* Horizon Orthopedic, Cleveland, Ohio
National Orthopaedic Imaging Associates, Menlo Park, California
Northwestern University, Evansville, Illinois

Address correspondence and reprint requests to Mark S. Schickendantz, MD, Horizon Orthopedic, 2709 Franklin Boulevard, Suite 6E, Cleveland, OH 44113

Background: To date, stress injury of the proximal ulna has been infrequently reported as a cause of elbow pain in the throwing athlete.

Purpose: We describe a syndrome of osseous stress injury of the proximal ulna in the professional throwing athlete.

Study Design: Retrospective review.

Methods: We evaluated the clinical, radiographic, and magnetic resonance imaging findings of seven professional baseball players with osseous stress injury of the proximal ulna.

Results: Plain radiographs of the involved elbows failed to demonstrate any significant findings. All of the clinically significant lesions were detected with magnetic resonance imaging. In addition, magnetic resonance imaging was found to be of value in following the course of healing of the injuries. All of the lesions originated on the posteromedial aspect of the proximal ulna. The ulnar collateral ligament was intact in all seven athletes. One athlete had two occurrences of this injury. Six of the seven athletes returned to their previous level of play after a nonoperative course of treatment.

Conclusions: We believe that this injury should be considered in the differential diagnosis of elbow pain in the throwing athlete. Magnetic resonance imaging is the diagnostic test of choice when this injury is suspected.

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