Osteoid osteomas are benign, typically intracortical lesions most often affecting the diaphysis of long bones. Nocturnal pain and characteristic symptoms that are relieved by administration of non-steroidal anti-inflammatory drugs (NSAIDs) are present and can help in the diagnosis of osteoid osteoma. We report a case of 18-year-old boy with an osteoid osteoma in the olecranon fossa with an atypical clinical manifestation. The initial manifestation was arthritis-like symptoms such as local heat, motion pain rather than pain at rest, and limited range-of-motion. Notably, NSAIDs were not effective at all for relieving his symptoms. Magnetic resonance imaging showed bone marrow edema around the elbow joint. The symptoms were resistant to conservative treatments, and thus, surgical resection was required. Histopathological examination showed that the lesion consisted of woven bones and osteoid tissues that anastomosed with each other. Combined with a tumor size that was less than 2 cm, clinicopathologically, the tumor was diagnosed as an osteoid osteoma. The pain was immediately relieved after the operation, and range-of-motion recovered at 2 months postoperatively. At 1 year after the surgery, the patient did not exhibit recurrence of the tumor or exacerbation of elbow pain and had a full range of elbow motion. Osteoid osteoma should be considered for the differential diagnosis of arthritis of the elbow in patients who are adolescents and young adults, which is the peak age of onset for osteoid osteoma.

In the elbow joint, occurrences of intra-articular osteoid osteoma are uncommon. We detail the case of a 21-year-old male who experienced pain, inflammation, and a restricted ability to move his elbow. For a few months, the diagnoses was missed and the patient was treated for idiopathic synovitis. After a contrast MRI, the tumor was revealed. During an arthroscopic examination of the elbow, a distinct red lesion was observed after the removal of the pale reactive bone in the olecranon cavity. This was subsequently removed in its entirety with the aid of a specialized bone tool. Histopathology confirmed the diagnosis of osteoid osteoma. Remarkably, the individual reported alleviation from the symptoms just a day following the operation and regained full range of motion 5 weeks after the surgery. This case underscores the efficacy of arthroscopy in addressing intra-articular osteoid osteoma, with a focus on accurately pinpointing the lesion.

UNASSIGNED: Posterior impingement of the elbow is not a common finding. Further investigation is ideal if impingement persists in spite of non-operative treatment.
UNASSIGNED: A male patient aged 33 years presented to us in the outpatient department with18 months history of impingement. Magnetic resonance confirmed soft-tissue as cause for impingement. Elbow arthroscopy revealed a rent in the olecranon fossa showing the fat pad locked into it. Debridement with arthroscopic shaver made the patient symptom free.
UNASSIGNED: Further investigation and minimal invasive elbow arthroscopy is recommended for persistent posterior elbow impingement.

OBJECTIVE: Radial neuropathy represents a devastating complication in a posterior approach to the distal humerus. This study aimed to propose \"safe zones\" regarding the radial nerve (RN) location at the posterior aspect of the humerus to minimize the risk of iatrogenic injury.
METHODS: In 100 embalmed specimens, the distances of the proximal edge of the olecranon fossa (OF) to the radial nerve at the medial edge (R1), at the center (R2) and at the lateral edge (R3) of the posterior aspect of humeral shaft were measured. Humeral length (HL) and transcondylar width (TW) were evaluated and correlated to R1, R2 and R3.
RESULTS: R1 was 15.0 (±2.1; 10.6-19.5) cm, R2 averaged 12.7 (±1.6; 8.9-15.7) cm, R3 was 10.6 (±1.3; 7.6-13.7) cm. HL was 30.8 (±1.9) cm. TW averaged 6.3 (±0.6) cm. TW and HL correlate with R1, R2, R3 (r = 0.451-0.565 [95% CI 0.279-0.685]). The mean ratio was 2.3 (±0.18) for HL/R1, 2.6 (±0.23) for HL/R2 and 3.1 (±0.31) for HL/R3. The ratio averaged 2.2 (±0.20) for R1/TW, 1.9 (±0.18) for R2/TW and 1.6 (±0.15) for R3/TW.
CONCLUSIONS: We present the OF as an osseous landmark to reduce the risk of iatrogenic radial neuropathy. HL and TW can be reliably used to estimate the RN location. The consistent \"safe zones\" of the RN in relation to the OF are 10.5 cm at the medial edge, 9 cm at the center and 7.5 cm at the lateral edge of the posterior aspect of the humeral shaft.

The supratrochlear foramen (STF) of the humerus is the aperture that forms when the septum separating the coronoid and olecranon fossa is perforated. There are no known studies in the literature on the STF among various South African ethnic groups. The presence and shapes of the STF were established by visual observation from a sample of 538 skeletonized individuals with paired humeri (1,076) and of equal numbers between the sexes. Measurements of the transverse (TD) and vertical (VD) distance of the STF were obtained using extended jaw calipers. An osteometric board was used to measure the epicondylar breadth (EB). Sliding calipers were used to measure the distance of the medial epicondyle to medial aspect of the STF (MB) and that of the lateral epicondyle to lateral border of the STF (LB). The prevalence of STF in the South African population was 32.5% and predominantly on the left with the highest incidence among the Sotho population (41%) and the lowest incidence in Whites (16%). Females (19.5%) had a higher frequency of the STF compared with males (13%). The STF occurred in oval (136), round (77), triangular (9), and irregular (34) shapes. The average EB in this study was 56.1 mm, whereas the average MB and LB were 25.4 mm and 26.3 mm, respectively. The average TD was 6.3 mm and average VD was 4.3 mm. These findings may be of clinical significance to surgeons and osteologists and may have anthropological or forensic importance.