Patients often present to the office for evaluation of pain because it stops their ability to play. They explain that they’ve been throwing and, after some detective work, I usually discover a history of excessive throwing and a sense that the throwing is becoming harder with more velocity. The patient can easily point to the location of pain on the inside part of the elbow. It only hurts with throwing and, typically, doesn’t hurt with routine activities such as carrying books, or other activities such as homework.
The examination is specific for two things: There is usually no ecchymosis or bruising and swelling, and no limitations in motion, but there’s simply direct tenderness when pushing on the area of bone at the growth plate and pain when stressing the elbow that puts tension on the growth plate
X-rays reveal that the area of the growth plate, which is usually one to two mm in thickness, has increased in size and may be double the normal width. MRI scans are usually not necessary as the diagnosis is made simply from the history, physical exam, and X-rays.