June 20, 2009

Capitellar Osteochondritis

A 10 yr old gymnast presented with right elbow pain

Timing of ossification center at elbow

Capitellum appears by 8 months

Radial head 3-4 yrs

Internal (medial) epicondyle 5 yrs

Trochlea 7 yrs

Olecranon 9 yrs

External (lateral) epicondyle 11 yrs

Capitellar osteochondritis

  • Results from overuse of elbow causing subchondral reactive process and loosening of cartilage and bone
  • Usually occurs at anterior surface of capitellum
  • Imaging findings show flattening of capitellar surface, or visible lucent zone of defect and sometimes can demonstrate intrarticular fragment of loose bodies.
  • Unstable lesions include large size (typically > 1 cm), cystic lesion beneath the osteochondrotic site, containing loose granulation tissue or loose fragement, fluid insinuating beneath the fragment
Reference Elbow In: Stoller DW, Tirman PFJ, Bredella MA . in Diagnostic Imaging: Orthopaedics. Amirsys.2003.

1 comment:

Rathachai Kaewlai, M.D. said...

Probably easier to remember as CRITOE - 1,3,5,7,9,11 yrs
The usefulness is that, at that certain age, you should be able to see the corresponding ossification centers at their normal location. If you don't, it may indicate trauma to the particular ossification center.

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