This is a 19-year-old male athlete and pitcher who was complaining of right elbow pain. He had seen an orthopaedist at the Hospital for Special Surgery and had an MRI, and he was diagnosed with a tear in the medial collateral ligament along the humeral attachment with the presence of bony edema. His physical exam was consistent with the diagnosis, with tenderness along the ulnar collateral ligament attachment along its proximal attachment at the humerus as well as the distal ulnar attachment. We visualized the ligament under ultrasound and there was presence of abnormal signals within the soft tissue and ligamentous structures consistent with edema and a tear.
The patient was treated with three sessions of ultrasound-guided autologous platelet-rich plasma graft to the ulnar collateral ligament along the medial aspect of the elbow. Prior to the last visit the patient reported no pain but he was not pitching and had not fully tested the elbow.
To be certain that we had improvement, we performed an MRI of the right elbow a month after the last treatment. The MRI demonstrated mild thickening and intermediate signal within the proximal aspect of the ulnar collateral ligament compatible with a prior mild sprain but the ulnar collateral ligament tear was no longer present. There was also resolution of the previously noted bone marrow edema that was seen on the initial study.
The patient will likely follow-up with us in two months, when he has his break from college, for re-evaluation and consideration of another treatment if needed.
