Furushima et al classified different types of olecranon stress fractures (OSF) in young Japanese baseball players based on changes seen in imaging studies. The authors are from Keiyu Orthopaedic Hospital in Gunma, Japan.
Patient selection: young baseball player (13 to 27 years) with olecranon stress fracture in throwing arm
Imaging studies may include:
(1) anterior-posterior X-ray
(2) lateral X-ray
(3) CT scan
(4) MRI scan
AP View
Lateral View
Type
fracture line from proximal-ulnar side and runs towards the distal radial side
fracture line runs from the olecranon articular surface in the dorsal-proximal direction
classic (oblique)
fracture line in the epiphyseal plate and runs vertical to the ulnar axis
fracture line runs from olecranon articular surface in the dorsal-distal direction
physeal
fracture line in the epiphyseal plate and runs vertical to the ulnar axis
fracture line runs from the olecranon articular surface in the dorsal-proximal direction
transitional
fracture line originates in the cortical notch of the trochlear groove
fracture line runs from the articular surface in the dorsal-distal direction
distal
sclerotic with indistinct fracture line
sclerotic with indistinct fracture line
sclerotic
Type
Features
classic (oblique)
common in adults
physeal
common in adolescents
transitional
physeal-like changes in the AP view and classic-like changes on the lateral view
distal
distal to that seen in the classic type. CT and MRI scans can be helpful for diagnosis
sclerotic
best diagnosed on MRI using T2-weighted images where an extensive low-intensity area is seen on the articular surface
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