title: Radiological analysis of the medial epicondyle in the adolescent throwing athlete.
abstract: BACKGROUND
  Injuries to the medial structures of the elbow due to overhead throwing games are well documented. However, variations of medial epicondyles are not well described, especially in athletes with fused medial epicondyles. In this study, we evaluated variations in the medial epicondyle of baseball players who were aged 15-17 years and had fused epicondyles.
  
  
  METHODS
  In this cross-sectional observational study, 155 skeletally mature baseball players with unilateral medial elbow pain and 310 elbow radiographs were reviewed by two independent reviewers. The medial epicondyles were categorised into three groups: normal, elongated or separated.
  
  
  RESULTS
  Among the 155 patients, 65 (41.9%) had normal epicondyles, 41 (26.5%) had elongated epicondyles and 49 (31.6%) had separated epicondyles. The medial epicondyle was larger on the dominant arm for 125 (80.6%) patients; the mean surface area on the dominant arm was 222.50 ± 45.77 mm2, while that of the non-dominant arm was 189.14 ± 39.56 mm2(p < 0.01). Among the three categories of medial epicondyles, separated epicondyles had the largest surface area, followed by elongated and normal epicondyles.
  
  
  CONCLUSIONS
  Medial epicondyles in adolescent throwing athletes can be categorised into three different groups according to their shape (normal, elongated and separated). We observed a correlation between the shape and the surface area of the medial epicondyle in adolescent throwing athletes, with separated medial epicondyles having the largest surface area. Further studies and follow-up are needed to determine the prognostic value and clinical significance of these morphological variations.
authors.affiliation: NOCERAL, Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wuey Min
authors.initials: WM
authors.lastname: Ng
authors.affiliation: NOCERAL, Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Chee Ken
authors.initials: CK
authors.lastname: Chan
authors.affiliation: Funabashi Orthopaedic Sports Medicine Center, Chiba, Japan.
authors.forename: Norimasa
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Funabashi Orthopaedic Sports Medicine Center, Chiba, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Kawai
authors.affiliation: NOCERAL, Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Kok Kheng
authors.initials: KK
authors.lastname: Teh
authors.affiliation: NOCERAL, Department of Orthopaedic Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: R
authors.initials: R
authors.lastname: Saravana
authors.affiliation: Funabashi Orthopaedic Sports Medicine Center, Chiba, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sugaya
mesh_terms: D000293:Adolescent; D056352:Athletes; D001265:Athletic Injuries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001484:Baseball; D003430:Cross-Sectional Studies; D004551:Elbow Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D011859:Radiography; D000092464:Elbow Injuries
keywords: Little League; elbow; injury; medial epicondyle