Is this elbow x-ray normal?

It's a common question and a difficult one to answer if there are not obvious periarticular osteophytes. There are however some subtle radiographic changes seen on a mediolateral view radiograph that are a good indicator of an underlying elbow problem -usually medial coronoid process (MCP) disease, aka fragmented coronoid process (FCP). One of these changes is sclerosis of the subtrochlear area of the ulna, but how do you know if it is sclerotic or not? An easy way to assess this is to look at the darker grey intramedullary cavity of the ulna distal to the elbow. If you follow this proximally and it narrows than it is sclerotic and abnormal. A second change is irregularity of the outline of the MCP. Check out the images below or on the PDF download which show both changes...

PDF version: Is this elbow normal?

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