Loose bodies in the elbow joint, also known as “loose bodies in the elbow” or “elbow joint loose bodies,” typically refer to small pieces of bone, cartilage, or other tissues that have become detached and are floating within the joint space. These loose bodies can cause pain, limited range of motion, and other symptoms. There are several potential causes for the development of loose bodies in the elbow joint:
Osteoarthritis
Osteoarthritis is a degenerative joint disease that can lead to the breakdown of cartilage in the elbow joint. As the cartilage wears away, small fragments of bone and cartilage can break off and become loose bodies in the joint.
Rheumatoid Arthritis
In rheumatoid arthritis, the body’s immune system attacks the synovium (the lining of the joint), leading to inflammation, joint damage, and the formation of loose bodies.
Trauma
A direct injury to the elbow joint, such as a fracture, dislocation, or severe contusion, can result in loose bodies. Bone fragments or cartilage may break off during the injury or as a result of subsequent healing processes.
Osteochondritis Dissecans (OCD)
OCD is a condition in which a piece of bone and cartilage in the joint loses its blood supply and starts to die. This can lead to the detachment of a loose body within the elbow joint.
Synovial Plica Syndrome
The synovial plica is a fold in the synovial lining of the joint. If it becomes irritated or inflamed, it can produce loose bodies or fragments of tissue that can float within the joint.
Infection
In rare cases, infections within the joint (septic arthritis) can lead to the formation of pus and debris, which can become loose bodies when the infection is not promptly treated.
Degenerative Changes
As a person ages, degenerative changes in the joint can occur, increasing the risk of loose bodies developing over time.
Symptoms of Loose Bodies in the Elbow Joint
Loose bodies in the elbow joint can cause a range of symptoms, which can vary in severity depending on the size, location, and number of loose bodies present. Common symptoms of loose bodies in the elbow include:
Pain
One of the most common symptoms is pain in the elbow joint. The pain may be dull, aching, or sharp and can vary in intensity. It is often exacerbated by movements that involve bending or extending the elbow.
Swelling
Swelling in the elbow joint is another common symptom. This swelling can be localised to the elbow area and may be accompanied by warmth and redness.
Limited Range of Motion
Loose bodies can impede the normal range of motion of the elbow joint. You may have difficulty fully extending or flexing your arm, and movements like bending or straightening the elbow can be painful and restricted.
Catching or Locking Sensation
Some individuals with loose bodies in the elbow joint may experience a sensation of the joint “catching” or “locking” during movement. This occurs when a loose body temporarily gets caught in the joint, causing discomfort or a momentary inability to move the elbow smoothly.
Clicking or Popping
Loose bodies can produce clicking or popping sounds when you move your elbow. These sounds are often due to the loose bodies moving within the joint space.
Weakness
Muscle weakness in the forearm and hand can occur because of the pain and restricted range of motion associated with loose bodies in the elbow.
Numbness or Tingling
In some cases, loose bodies may put pressure on nearby nerves, leading to numbness or tingling sensations in the arm or hand.
Treatment Options
The treatment of loose bodies in the elbow joint typically depends on the size, location, and number of loose bodies, as well as the underlying cause of their formation. Here are some common treatment options:
Conservative Management
Rest: Avoid activities that worsen symptoms and give the elbow time to heal.
Ice: Applying ice to the affected area can help reduce pain and swelling.
Pain Medications: Over-the-counter pain relievers or prescription medications may be used to manage pain and inflammation.
Physical Therapy: A physical therapist can provide exercises and modalities to improve range of motion, strengthen the surrounding muscles, and promote joint stability.
Corticosteroid Injections: In some cases, a healthcare provider may recommend corticosteroid injections to reduce inflammation and pain in the elbow joint.
Arthroscopic Surgery
Arthroscopy is a minimally invasive surgical procedure used to remove loose bodies from the elbow joint. During arthroscopy, a surgeon makes small incisions and uses a tiny camera and specialised instruments to visualise and remove the loose bodies. This approach allows for a quicker recovery and less postoperative pain compared to open surgery.
Open Surgery
In cases of larger or more complex loose bodies, open surgery may be necessary. This involves a larger incision and direct visualisation of the joint to remove the loose bodies and address any underlying issues.
Joint Lavage and Debridement
In some instances, joint lavage (flushing the joint with a sterile solution) and debridement (removing damaged tissue) may be performed to address inflammation and clean out the joint.
Medication or Treatment for Underlying Conditions
If the loose bodies are associated with an underlying condition such as arthritis, rheumatoid arthritis, or infection, the primary condition should be treated to prevent the recurrence of loose bodies.
Rehabilitation
After surgery, physical therapy and rehabilitation are often essential to regain full range of motion, strength, and function in the elbow joint.
Case Example
A man presented with pain and locking symptoms of his right elbow. He had been active in the gym doing weight training for many years. He noticed that he could not fully extend his right elbow gradually over time. The inability to fully extend his right elbow did not interfere with his activities of daily living and he did not seek any treatment. He only consulted a doctor when the right elbow started to jam and lock from time to time and it was getting painful whenever it occurred.
MRI of his right elbow showed degenerative changes of his right elbow from osteoarthritis as well as presence of multiple loose bodies in the joint. The largest one was at the back of his right elbow at the area called the olecranon fossa. This prevented him from straightening out his right elbow.
I performed elbow arthroscopy to remove the loose bodies from his right elbow.
A large loose body was found in the olecranon fossa of his right elbow:
Multiple loose bodies were removed from his right elbow joint. Four small arthroscopic keyholes were used to perform this surgery.
