MRI findings of bilateral proximal radial physeal injury in a gymnast

Abstract

Recent advances in imaging techniques shed light on anatomical variants considered normal historically in medical literature. We present an 11-year-old gymnast with unilateral left elbow pain and unusual symmetrical radiographic findings of both elbows that initially raised the question of normal variant cleft epiphysis of the proximal radius. Further imaging with MRI demonstrated bilateral elbow injury that is likely repetitive and chronic rather than an anatomical variant. Post-treatment MRI showed improved changes with rest and non-steroidal anti-inflammatory medications. These findings emphasize the need for vigilance and further investigation when diagnosing a normal variant, particularly in an athlete.