What is this nine-year-old’s unusual gymnastics injury?

This 9-year-old presents with an elbow injury from gymnastics. What is the mechanism? What does the solitary arrow indicate? What is the accompanying soft tissue injury? What do the double arrows indicate?

The findings are the result of an acute valgus insult. The capitellum (single arrow) is edematous, a sign of this mechanism. The soft tissue injury is that the ulnar collateral ligament is torn proximally, an unusual injury in a 9-year-old. There is an avulsed ulnar collateral ligament from its origin as stated above (double arrows). For more case review, head to MRI Online.

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