summary Olecranon Stress Fractures are rare elbow injuries that predominately affects throwing athletes. Diagnosis can usually be made with plain radiographs of the elbow but may require an MRI or CT scan to confirm the diagnosis in the early stages. Treatment is generally rest from pitching, pain control, and brief period of immobilization. Epidemiology Anatomic location predominantly involves the epiphyseal plate fractures line may propagate to be either transverse or oblique in orientation Etiology Pathophysiology mechanism of injury three commonly accepted theories login to view 3 more bullets Associated injuries with throwing movements ulnar collateral ligament tears medial epicondyle avulsion fracture Presentation Symptoms posteromedial olecranon pain of the throwing arm improves with rest worse with throwing movements Physical exam inspection mild swelling over olecranon localized tenderness motion valgus instability stress test login to view 1 more bullet Imaging Radiographs recommended views AP, lateral, oblique views of elbow optional views valgus stress views contralateral elbow for comparison findings physeal widening, delayed fusion, or fragmentation widening of the medial joint space with UCL injuries CT views best seen on lateral views findings typical fracture pattern login to view 2 more bullets MRI indications suspected UCL tear views coronal T2 fat-saturated views findings T-sign indicative of UCL tears Treatment Nonoperative short-term administration of NSAIDS, rest +/- temporary splinting indications login to view 1 more bullet modalities login to view 5 more bullets Operative open internal fixation indications login to view 1 more bullet modalities login to view 2 more bullets