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The purpose of this paper is to describe a case of heterotopic ossification of the ulnar collateral ligament in a 29-year-old top level weightlifter. Plain radiography of the elbow determined the extent and location of heterotopic ossification. Ultrasound and MR imaging completed the instrumental setup. This symptomatic case had the resolution of pain after 2 months of a supervised rehabilitation program. At one year follow-up the athlete is asymptomatic referring occasional minor pain only in the periods of vigorous training.
KEY WORDS: Elbow - Ulnar collateral ligament - Heterotopic ossification, weightlifting.
Heterotopic ossification is a poorly understood condition characterized by the formation of bone in periarticular regions.1 One of the joints most frequently affected is the elbow where heterotopic ossification often can lead to severe limitation of motion and pain. The ulnar collateral ligament (UCL) forms the primary constraint of the elbow joint to valgus stress.2-4
Heterotopic calcification in the UCL may be associated with UCL tear or injury especially in throwing athletes.5-7
The purpose of this paper is to describe the unusual case of heterotopic calcification of UCL reported in a top level weightlifter.
Case report
K. I., a 29-year-old female weightlifter (Figure 1), who have been practicing for 17 years, member of woman national team, referred to our Institution in October 2003 complaining pain over the medial aspect of the right elbow, during the last 2 months and worsening the last ten days before evaluation. In her clinical history she reported that one year before during a competition while she was carrying out a snatch lift with 80 kg catching the bar overhead she felt a sensation of giving away and pain on the medial aspect of her right elbow, as she had strained a muscle. She did not undergo any specific instrumental investigation, rested for 4 weeks, following a physical therapy program and she gradually resumed her specific activity with no limitation.
The clinical assessment revealed the presence of tenderness over the UCL, pain during the flexion-extension motion and valgus stress. This maneuver was performed with the forearm supinated and elbow flexed at 30°. The right elbow demonstrated more laxity in valgus stress and more hyperextension than the contralateral. Radiographs performed in standard and axial projections demonstrated a large ossification of...