Case 14

History
51 year old female with history of melanoma now with left elbow pain.

 
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Diagnosis?

    

Findings
There is a bony protuberance at the anteromedial aspect of the distal humerus pointing towards the joint.  
             
Diagnosis
Supracondylar process (normal variant)
 
Discussion
A supracondylar process is an osseous projection off the distal humerus.  This is a normal variant occurring in about 1% of the population. The supracondylar process projects towards the joint. Osteochondromas on the other hand usually point away from the joint.

In some patients, a fibrous band known as the ligament of Struthers connects the process to the medial epicondyle. This ligament can entrap the median nerve and/or the brachial artery. This anomalous ligament provides an anomalous site of attachment for the coracobrachialis muscle and a portion of the pronator teres muscle.

References
Resnick D. Neuromuscular Disorders. In: Resnick D, ed. Diagnosis of Bone and Joint Disorders. 3rd ed. Philadelphia, PA: W.B. Saunders Co;1995

 

Submitted by Rahul Patel, M.D.
Reviewed by Paul Clifford, M.D.