Intended for healthcare professionals

Endgames Spot Diagnosis

A young man with elbow pain

BMJ 2017; 357 doi: (Published 11 May 2017) Cite this as: BMJ 2017;357:j1820
  1. Julia Myers, clinical fellow in brain injury rehabilitation
  1. Frenchay Brain Injury Rehabilitation Centre, Frenchay Park Road, Bristol, UK
  1. Correspondence to J Myers julia.myers{at}

A 24 year old man presented with pain and reduced pronation/supination of his right elbow that had been worsening over the past three months. He had sustained a traumatic brain injury six months before presentation and was undergoing inpatient rehabilitation for a right hemiparesis. Radiographs of the elbow were taken (figs 1, 2). Based on these images and the patient’s history, what is the diagnosis?

Fig 1 Lateral radiograph of the right elbow

Fig 2 Anteroposterior radiograph of the right elbow


There is extraskeletal bone formation in the soft tissue adjacent to the radial tuberosity. This is consistent with neurogenic heterotopic ossification.


Neurogenic heterotopic ossification is a benign …

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