0:00

There is a lesion that has been described in the

0:05

baseball pitcher who is, uh, a youngster.

0:10

And it's a trochlear osteochondral injury.

0:13

It leads to irregularity, cystic change,

0:15

and sometimes a bone concavity located here

0:20

between the trochlear and the Capella.

0:23

This can become quite large, large enough.

0:27

So you can see it with routine radiography, as in this case.

0:31

I think I have another one.

0:33

Here's another example of that, not quite as prominent,

0:37

but this is a trochlear osteochondral injury.

0:41

And then another problem

0:42

that we can see in baseball pitchers

0:45

and other athletes are stress fractures involving the iliac.

0:50

Classically, they begin deep on the deeper surface

0:53

and they extend in a linear

0:55

and often oblique fashion toward the posterior surface.

0:59

Here is one example of what one might look like.

1:02

I've seen a lot of these.

1:03

Here's another one shown by ct and mr.

1:07

That's almost a, a, uh, complete fracture involving the oc.

1:12

Here's one that we followed over 18 months.

1:17

Here's what it looked like.

1:18

Initially, it was kinda limited to the deep surface

1:21

of the eon.

1:23

It healed. You can see low signal reflecting bone sclerosis.

1:27

And then what happened is a re fracture occurred

1:31

through that area.

1:34

One further example where a stress fracture progressed

1:37

to a complete fracture involving, uh, the ilium.

1:43

And my last slide, I wanted to show you boxer's, elbow,

1:48

'cause boxer's, elbow can lead to a peculiar pattern

1:51

of bone proliferation that occurs postal laterally.

1:55

I'm showing you diagrammatically.

1:58

I'll show you that in one case, reported in the literature

2:02

in full extension

2:04

and pronation,

2:05

one may get impingement involving this region of the elbow.

2:10

So it's kind of on the lateral side, not on the medial side.

2:15

So what I've done in, uh, my allotted period of time,

2:19

actually a little bit shorter than that, I've kind of gone

2:21

through elbow stability and instability.

2:26

I've emphasized the critical ligaments.

2:28

I know we've gone into a lot of anatomy, which for some

2:31

of you may, uh, be a little bit too much at the beginning,

2:35

but hopefully it'll give you an idea

2:37

of what you have to learn.

2:39

If you wanna understand what is a stable elbow

2:43

and what is an unstable elbow.