Olecranon-Is this a fracture?

A child with injury and pain. Resident-Professor series by Dr MGK Murthy.

1.      What is  the finding

Well defined opacity seen in the tip of olecranon in the proximal part with no donor site or significant soft tissue abnormality.

2.      What is it?

At first look it looks like fracture. But absence of Soft issue and donor site should warrant other possibilities

3.      What are they?
Olecranon is known to  start  to ossify by secondary ossification centre between  9 -10 yrs and can appear up to 11 yrs.

4.      What about satellite opacity?

it could represent unusual bipartite or multipartite olecranon in some children

5.      Any other possibility?

Yes occasionally we get patella cubitus –sesamoid bone in the tendon of triceps which ultimately fuses with olecranon

6.      What will help now ?

Since then is no local tenderness we can wait for 2 weeks and repeat by the usual rule of Law of TWO- broken bone will never remain same density.

7.      Any role for cross sectional imaging?

MR would help but not mandatory as the treatment with this is conservative and  we have cost effective alternative of follow up xray.