Elbow Pain
MEDIAL EPICONDYLE APOPHYSITIS
Medial epicondyle apophysitis affects throwing athletes, such as pitchers. Frequent throwing results in repetitive stress across the medial epicondyle growth plate.31,32 Patients present with pain localized directly over the medial epicondyle. Tenderness may be mild in early apophysitis, but can be severe if there is an avulsion fracture. The shoulder also should be examined because this condition can be a symptom of shoulder pathology. Plain radiographs may show fragmentation of the medial epicondyle.
Prevention is the best treatment for this condition and should include pitch limits, with limitation of curveballs and sliders in particular.33–35 Descriptive studies have shown that pitching curveballs and sliders exerts excessive torque across the shoulder and elbow joints, respectively.34,36 Successful treatment typically consists of ice, acetaminophen or NSAIDs, and throwing cessation.37 Surgical management is generally not necessary, but may be reserved for widely displaced avulsion fractures.