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A 12-year-old baseball pitcher describes progressive worsening of medial elbow pain on his throwing side. Examination reveals normal elbow range of motion. He is tender over the medial elbow to palpation. A dynamic ultrasound of his elbow shows no evidence of medial widening with valgus stress. His radiograph is shown in Figure A and an MRI is shown in Figure B. What is the most likely cause of his symptoms?
Displaced medial epicondyle avulsion fracture
Medial ulnar collateral ligament tear
Valgus extension overload with olecranon osteophytes
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A 10-year-old little league pitcher has the triad of medial elbow pain in his throwing arm, decreased throwing effectiveness, and decreased throwing distance. What is the pathogenesis of the condition that is most likely to be occuring in this patient?
Acute fragmentation of the entire capitellar ossific nucleus
Rupture of the anterior band of the anterior bundle of the ulnar collateral ligament
Repetitive contraction of the flexor-pronator mass stresses the chondro-osseous origin, leading to apophysitis
Microtraumatic vascular insufficiency of the capitellum from chronic compressive and rotatory forces
Repetitive triceps contraction during extension
A 6-year-old Little League pitcher has had pain in the right elbow for the past 2 weeks. Examination reveals mild lateral elbow joint tenderness with full range of motion and no effusion or collateral laxity. A radiograph is shown in Figure 38. Initial management should consist of
cessation of throwing activities.
a long arm cast for 3 months.
a corticosteroid injection into the elbow joint.
excision of the fragment.
arthroscopic drilling of the lesion.