The medial epicondyle is the medial prominence of the distal humerus serving as the origin for the common flexor tendon (FCR, FCU, PL, FDS, pronator teres) and the attachment of the ulnar collateral ligament (UCL). It is located subcutaneously and directly palpable, making it the reference for medial elbow pain localisation.
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| Landmarks |
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| Ossification | The medial epicondyle apophysis (I in CRITOE, Internal epicondyle) appears at age 5 to 6 and is often the last elbow centre to fuse, at about 15 to 17, so it commonly appears separate on adolescent radiographs. |
Medial epicondyle avulsion fractures in adolescents from valgus stress (throwing, wrestling) or elbow dislocation can trap the fragment inside the joint, blocking motion. Incarcerated or significantly displaced fragments need surgical extraction and fixation. In adults, medial epicondylalgia (golfer elbow) is the equivalent overuse injury to lateral epicondylalgia, producing medial epicondyle tenderness at the common flexor origin. The ulnar nerve in the cubital tunnel immediately posterior to the medial epicondyle is vulnerable to trauma and cubital tunnel syndrome, and is decompressed by releasing the overlying retinaculum.
Feel on the inner side of the elbow for the large, sharp bony projection; this is the medial epicondyle, the origin of the forearm flexors. Just behind it, in the groove between it and the olecranon, the ulnar nerve can be rolled gently under the finger (the funny bone).
In adolescents, valgus stress or elbow dislocation avulses the apophysis, which may become trapped in the joint.
Degeneration of the common flexor origin causing medial elbow pain with gripping and wrist flexion.
Traction apophysitis of the medial epicondyle in young pitchers from repetitive valgus throwing stress.
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