The purpose of this study was to identify the distinguishing features of primary elbow osteoarthritis as opposed to normal aging. This is a retrospective study of 50 patients who presented with elbow pain, locking or reduced motion, with a diagnosis of clinical osteoarthritis. All patients with a previous history of trauma or rheumatologic disease were excluded. Frontal and lateral x-rays of the elbow were taken and reviewed. These x-rays were then compared to an age and sex matched control group. Both groups were evaluated for the presence of the features of osteoarthritis, which specifically were enumerated as:
1. Olecranon osteophyte
2. Coronoid osteophyte
3. Radial head osteophyte
4. Radial and coronoid fossa osteophytes
5. Radiocapitellar joint space narrowing
6. Ulnar trochlear joint space narrowing
7. Thickening of the olecranon fossa membrane
8. Loose bodies
9. Ulnar collateral ligament calcification
The results of this study demonstrate that osteophyte formation at the olecranon, coronoid, and radial head were the most frequent findings in patients with primary osteoarthritis of the elbow. In addition, the olecranon osteophytes, coronoid osteophytes, radial head osteophytes, olecranon fossa membrane thickening, coronoid and radial fossa osteophytes, and radiocapitellar joint space narrowing were statistically more common in the osteoarthritic group in the age and sex matched controls.
Distinguishing primary osteoarthritis from normal aging is a difficult radiographic distinction. In this study, osteophyte formation has been found to be the most common radiographic feature of the osteoarthritic elbow, and most importantly occurs at the tip of the olecranon and the coronoid process. It is of interest that a coronoid osteophyte was noted in 36% of patients in the control group, suggesting that osteophyte formation on the coronoid may be a feature of normal aging.
Elbow, Osteoarthritis, Aging, Osteophytes
J of Shoulder and Elbow Surg