602 - Atraumatic Olecranon Avulsion Fracture in a Professional Baseball Player: Ultrasound and Functional Assessment

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

DS

Dagmawi Shimeles, BS

Medical Student
Macon & Joan Brock Eastern Virginia Medical School at Old Dominion University, Norfolk, VA, USA
Alexandria, Virginia, United States

Co-Author(s)

KS

Kyle Stawitzky, DO

Primary Care Sports Medicine Fellow
Detroit Medical Center
Warren, Michigan, United States
BK

Brandon Kakos, MD

Program Director, Primary Care Sports Medicine Fellowship
Detroit Medical Center
Warren, Michigan, United States

Submitter(s)

DS

Dagmawi Shimeles, BS

Macon & Joan Brock Eastern Virginia Medical School at Old Dominion University, Norfolk, VA, USA
Alexandria, Virginia, United States

Case Diagnosis: Displaced atraumatic olecranon avulsion fracture, right elbow

Case Description: A 25-year-old right-hand-dominant professional baseball player experienced acute posterior elbow pain and swelling during warm-up after repetitive hyperextension without direct trauma. Despite minimal pain at presentation, residual triceps weakness persisted, indicating functional impairment. Examination revealed mild posterior swelling, ecchymosis, triceps strength 3+/5, full flexion–extension (0–140°), and preserved pronation/supination (80° each). Radiographs confirmed a displaced atraumatic olecranon avulsion fracture. Point-of-care ultrasound clarified triceps tendon integrity and detected joint effusion, differentiating this injury from tendon rupture and informing the timing and urgency of surgical referral. The elbow was immobilized in a posterior splint (45–90° flexion) to maintain fracture alignment and minimize further displacement.

Discussions: Atraumatic olecranon avulsion fractures from repetitive hyperextension in overhead athletes are rare but clinically significant. This case illustrates that substantial structural injury can present with minimal pain yet measurable functional deficit, emphasizing careful evaluation of elite throwers. Point-of-care ultrasound provided rapid, actionable insight by confirming tendon integrity, ruling out additional soft tissue injury, and supporting timely surgical referral. Even subtle deficits in strength or range of motion can compromise throwing performance, highlighting the importance of comprehensive functional assessment. Clinicians should recognize that minimally symptomatic injuries in elite athletes may conceal significant structural damage, and thorough evaluation can guide timely management. This case demonstrates the value of integrating functional assessment, point-of-care imaging, and early referral to support safe return-to-sport strategies in overhead athletes.

Conclusions: This case highlights a rare, atraumatic olecranon avulsion in a professional baseball player, emphasizing the physiatrists’ role in early diagnosis, functional assessment, and structured return-to-sport planning. Point-of-care imaging provided critical, actionable insight, informing both surgical referral and rehabilitation guidance. Clinicians should maintain high suspicion for subtle, minimally symptomatic injuries in overhead athletes to prevent functional deficits and optimize performance.