Age / Sex : 32 / M

Chief complaint: elbow joint dislocation after trauma

1) What is your impression?

Two weeks later, you can see the final diagnosis with a brief discussion of this case.

(Quiz는 quiz일 뿐이오니 답안은 한개만 보내주시기 바라오며, 복수의 답안을 보내주시는 분은 정답이 포함되어 있더라도 부득이 semi-correct answer로 처리토록 하겠습니다.)

Courtesy:  김태은 (Tae Eun Kim), 대구파티마병원 (Daegu Fatima hospital)

Osborne-Cotterill lesion (posterior capitellar impaction injury)

Discussion

Findings: Plain radiographs show elbow joint dislocation with fracture of lateral
aspect of distal humerus. There is depression fracture of the capitellum and
the lateral condyle.    

Differential
Diagnosis: pseudodefect of the capitellum

Diagnosis:
Osborne-Cotterill lesion (posterior capitellar impaction injury) 

Discussion:
In 1966, Osborne and Cotterill first described a capitellar defect in
recurrent elbow dislocation as similar to the glenoid defect(bony Bankart
lesion) observed in recurrent shoulder dislocation. Detachment of the
capsuloligamentous structure with osteochondral defect of the glenoid observed
in recurrent shoulder dislocation is analogous to the osseous defect occurring
at the posterolateral capitellum, which is associated with posterolateral rotator
instability of the elbow.

Therefore, Osborne-Cotterill lesion (posterior
capitellar impaction injury) highly suggest the coexistence of previous elbow
dislocation or posterolateral rotator instability.   

References: 1. Jeon IH , Micic ID , Yamamoto N , Morrey
BF. Osborne-Cotterill lesion: an osseous defect of the capitellum associated
with instability of the elbow . AJR Am J Roentgenol 2008 ; 191 ( 3 ): 727 – 729
.

2. Rosenberg ZS , Blutreich SI , Schweitzer
ME, Zember JS , Fillmore K . MRI features of posterior capitellar impaction
injuries . AJR Am J Roentgenol 2008 ; 190 ( 2 ): 435 – 441 .