Fracture through an enthesophyte on the olecranon process

Area of Science:

• Orthopedics
• Sports Medicine
• Radiology

Background:

• Direct-access physical therapy allows patients to seek care without physician referral.
• Elbow pain is a common complaint, particularly in active populations.
• Enthesophytes are bony spurs that form at tendon or ligament insertions.

Observation:

• A 54-year-old active-duty military member presented with a 3-week history of left elbow pain.
• Evaluation was performed by a physical therapist in a direct-access setting.
• Radiographs were obtained to investigate the cause of pain.

Findings:

• Radiographic imaging revealed a linear lucency.
• This lucency was located within a large enthesophyte at the triceps tendon insertion site on the olecranon process.
• The findings were consistent with an avulsion fracture.

Implications:

• This case highlights the utility of direct-access physical therapy in diagnosing musculoskeletal injuries.
• Olecranon enthesophyte fractures may be an underrecognized cause of elbow pain in active individuals.
• Accurate radiographic interpretation is crucial for appropriate management of elbow pain.