-Cyprus Orthopaedics

Elbow Loose Bodies

Loose bodies in the elbow are small fragments of bone or gristle, which are floating in the joint. They may arise from an injury or from wear and tear changes in the joint. The condition usually presents with symptoms of catching or locking of the joint, which may or may not be painful.
Elbow Conditions-Cyprus Orthopaedics

Elbow Loose Bodies

Elbow loose bodies can be a perplexing condition, causing discomfort and limited mobility for those affected. These loose bodies, also known as loose fragments or loose cartilage, are small pieces of bone or cartilage that become dislodged within the elbow joint. While they may seem insignificant, they can lead to pain, inflammation, and restricted movement. In this article, we will delve into the causes, symptoms, and treatment options for elbow loose bodies, providing you with the information you need to understand and address this condition.

Causes of Elbow Loose Bodies

The causes of elbow loose bodies can vary, but they often arise due to trauma or repetitive stress on the elbow joint. In some cases, a sudden injury, such as a fall or direct blow to the elbow, can cause a bone or cartilage fragment to break free and become loose. Other times, repetitive movements, such as those commonly performed in certain sports or occupations, can gradually wear down the cartilage and cause fragments to dislodge. Additionally, certain medical conditions, such as osteoarthritis or rheumatoid arthritis, can contribute to the formation of loose bodies in the elbow joint.

Symptoms of Elbow Loose Bodies

The symptoms of elbow loose bodies can vary from person to person, but there are several common signs to watch for. One of the most prevalent symptoms is pain, which may be felt as a dull ache or a sharp, stabbing sensation. The pain is often exacerbated by movements that put stress on the elbow joint, such as gripping or lifting objects. Another frequent symptom is swelling around the elbow, which may be accompanied by redness and warmth. In some cases, the loose bodies may cause a clicking or locking sensation within the joint, making it difficult to fully extend or bend the arm. If you experience any of these symptoms, it is important to seek medical attention for a proper diagnosis and treatment plan.

Diagnosing Elbow Loose Bodies

Diagnosing elbow loose bodies typically involves a combination of medical history review, physical examination, and imaging tests. During the medical history review, your doctor will ask about your symptoms, any previous injuries or traumas to the elbow, and your occupation or activities that may put stress on the joint. A physical examination will be conducted to assess the range of motion, strength, and stability of the elbow. Your doctor may also perform specific tests, such as applying pressure to the joint or manipulating it in certain ways, to elicit pain or clicking sensations.

To confirm the presence of elbow loose bodies and evaluate their size and location, imaging tests such as X-rays or MRI scans may be ordered. X-rays can reveal any calcified fragments or changes in bone density, while MRI scans can provide detailed images of the soft tissues and cartilage within the joint. These diagnostic tools help your doctor determine the best course of treatment for your specific condition.

Treatment Options for Elbow Loose Bodies

The treatment options for elbow loose bodies depend on the severity of your symptoms, the size and location of the loose bodies, and your overall health. In some cases, non-surgical treatments may be sufficient to alleviate discomfort and restore normal function. However, if conservative approaches fail to provide relief, or if the loose bodies are causing significant joint damage, surgical intervention may be necessary.

Non-surgical Treatments for Elbow Loose Bodies

Non-surgical treatments for elbow loose bodies focus on reducing pain and inflammation, as well as improving joint mobility and strength. These may include:

  • Rest and activity modification: Avoiding activities that aggravate the symptoms and allowing the elbow joint to rest and heal.
  • Physical therapy: Under the guidance of a qualified therapist, performing exercises and stretches to improve joint range of motion and strengthen the surrounding muscles.
  • Pain management: Over-the-counter pain medications or prescribed anti-inflammatory drugs can help alleviate pain and reduce swelling.
  • Corticosteroid injections: In some cases, a corticosteroid injection may be administered directly into the joint to provide temporary pain relief and reduce inflammation.

Surgical Treatment

To eliminate a loose body in the elbow, surgeons employ arthroscopic surgery, a minimally invasive procedure involving small incisions approximately one centimeter in length. Through one of these incisions, an arthroscope—a slender, flexible tube fitted with a specialized camera—is inserted to locate the loose body. Concurrently, through the other incisions, specific instruments are introduced to extract the loose body.

Rehabilitation and Recovery after Treatment

Regardless of the chosen treatment approach, rehabilitation and recovery play a crucial role in restoring optimal function and preventing future complications. Following surgery or during non-surgical treatment, a physical therapy program will be prescribed to gradually regain strength, flexibility, and range of motion in the elbow joint. This may involve exercises, stretches, and other therapeutic techniques tailored to your specific needs. It is important to follow the guidance of your healthcare provider and adhere to the recommended rehabilitation plan to achieve the best possible outcome.

Small fragments of bone or articular cartilage (“gristle”) may break off from the bearing surface or margins of the joint as a result of an injury. When the joint suffers wear and tear, spurs may form at the margins and occasionally these may break off and become loose in the joint. These fragments may start small but occasionally enlarge over time. When they get trapped between the bearing surface they impede movements and cause symptoms of locking where the joint may become jammed for a short period of time. 

A diagnosis of loose bodies is made based on the history of locking or catching of the elbow. Pain is usually intermittent. Examination of the joint may be unremarkable but may sometimes show loss of movement at the end of the range. An X-ray may be performed to look for bony loose bodies. An ultrasound scan is performed to examine the state of the tendons. Special imaging with an MRI or CT scan is often necessary to look at the bearing surface.

If the symptoms are mild or infrequent, then they may simply be monitored. Troublesome symptoms may require surgical treatment. 

Surgery: In some patients, in whom symptoms are troublesome or interfere with sports or work, it may be appropriate to undertake surgical treatment.  Surgery consists of arthroscopy (“key-hole” surgery) to remove the loose bodies from the joint. For further information on surgical treatment, please refer to the section on “Elbow Arthroscopy”.  

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