A man in his 40s presents to urgent care with 3 days of worsening pain in his right elbow, numbness in his right pinky and ring fingers, and numbness in the right hand. The symptoms began after he participated in a tug-of-war game 4 days ago. The patient reports that he fractured his right elbow 6 years ago. He denies any neck pain, symptoms in his legs or other arm, fever, or other complaints.

Examination

All of the patient’s vital signs are within normal range, and the results of a physical examination are normal except for anesthesia in the right little finger and half of the ring finger, as well as weakness to finger spread and opposition. Radiographic imaging of the right elbow shows hypertrophic bony arthritis of the elbow.

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