Refractory Ulnar Nerve Symptoms in an Adolescent Pitcher With Medial Apophysitis

A 16-year-old high school baseball pitcher with a 3-week history of acute-onset pain in his medial elbow during throwing presented to physical therapy. Following examination, physical therapy was initiated and the patient was referred for imaging, with suspicion of ulnar collateral ligament (UCL) injury. Radiographs were noncontributory. Ultrasound imaging, however, was performed by a physiatrist and was suggestive of a partial-thickness tear of the UCL and ulnar nerve enlargement. The physiatrist ordered magnetic resonance imaging, which confirmed a medial apophyseal stress reaction, a mild UCL sprain, and reactive ulnar nerve edema. J Orthop Sports Phys Ther 2018;48(5):419. doi:10.2519/jospt.2018.7359.