Paediatric orthopaedics: Little leaguer's elbow: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Paediatric orthopaedics: Little leaguer's elbow

Sample item

A 13-year-old baseball pitcher has medial elbow pain with throwing and tenderness over the medial epicondyle. Radiographs show widening and fragmentation of the medial epicondylar physis. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Medial epicondylar apophysitis (Little leaguer's elbow)

Repeated valgus stress during throwing causes traction by the flexor-pronator mass on the medial epicondylar apophysis. Treatment is rest from throwing and a gradual return, with pitch counts and technique correction. Continued throwing may result in avulsion of the epicondyle.

Option by option

  • A. Panner disease

    Panner disease affects the capitellum on the lateral side of the elbow in children under 10.

  • B. Radial head subluxation

    Radial head subluxation (nursemaid's elbow) follows a sudden pull on the hand in toddlers.

  • C. Medial epicondylar apophysitis (Little leaguer's elbow) (correct)

    Correct. Valgus overload of the medial epicondylar physis in a young thrower is Little leaguer's elbow.

  • D. Lateral epicondylitis

    Lateral epicondylitis affects the common extensor origin in adults and causes lateral elbow pain.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is C, Medial epicondylar apophysitis (Little leaguer's elbow). Repeated valgus stress during throwing causes traction by the flexor-pronator mass on the medial epicondylar apophysis.

Why is "Panner disease" not the answer?

Panner disease affects the capitellum on the lateral side of the elbow in children under 10.

Why is "Radial head subluxation" not the answer?

Radial head subluxation (nursemaid's elbow) follows a sudden pull on the hand in toddlers.

Why is "Lateral epicondylitis" not the answer?

Lateral epicondylitis affects the common extensor origin in adults and causes lateral elbow pain.

What concept does this question test?

It tests Paediatric orthopaedics: Little leaguer's elbow in Orthopaedics. Treatment is rest from throwing and a gradual return, with pitch counts and technique correction. Continued throwing may result in avulsion of the epicondyle.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric orthopaedics: Little leaguer's elbow?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.