Loose bodies in the elbow are small fragments of bone or gristle, which are floating in the joint. They may arise from an injury or from wear and tear changes in the joint. The condition usually presents with symptoms of catching or locking of the joint, which may or may not be painful. 

What is the pathology of loose bodies in the elbow?

Small fragments of bone or articular cartilage (“gristle”) may break off from the bearing surface or margins of the joint as a result of an injury. When the joint suffers wear and tear, spurs may form at the margins and occasionally these may break off and become loose in the joint. These fragments may start small but occasionally enlarge over time. When they get trapped between the bearing surface they impede movements and cause symptoms of locking where the joint may become jammed for a short period of time. 

How are loose bodies diagnosed?

A diagnosis of loose bodies is made based on the history of locking or catching of the elbow. Pain is usually intermittent. Examination of the joint may be unremarkable but may sometimes show loss of movement at the end of the range. An X-ray may be performed to look for bony loose bodies. An ultrasound scan is performed to examine the state of the tendons. Special imaging with an MRI or CT scan is often necessary to look at the bearing surface.

What is the treatment for loose bodies in the elbow?

If the symptoms are mild or infrequent, then they may simply be monitored. Troublesome symptoms may require surgical treatment. 

Surgery: In some patients, in whom symptoms are troublesome or interfere with sports or work, it may be appropriate to undertake surgical treatment.  Surgery consists of arthroscopy (“key-hole” surgery) to remove the loose bodies from the joint. For further information on surgical treatment, please refer to the section on “Elbow Arthroscopy”.