{'fraction_non_alphanumeric': 0.020786516853932586, 'fraction_numerical': 0.0050561797752808986, 'mean_word_length': 4.839344262295082, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Bilateral osteochondritis dissecans in a female pitcher. A case report and review of the literature.

The patient is a 17 year old right handed female multi-sport athlete. She was active in high school volleyball, basketball, and was a softball pitcher. She presented with the complaint of several years of intermittent right elbow pain and swelling. Approximately three months prior to presentation she noted pain and swelling, with new symptoms of grinding, locking and decreased range of motion. She denied a history of acute trauma. She continued sports with no loss of playing or practice time. Past medical history was negative for any other joint pathology or endocrine disorders. Family history was negative for any bone or joint problems. Exanmination of her right elbow revealed no obvious swelling. There was slight tenderness to palpation anteriorly over the antecubital fossa. There was no joint line tenderness to palpation. Active range of motion was 0-130 degrees with audible grinding. There was loss of extension compared to the opposite, asymptomatic elbow. She was able to demonstrate full active pronation and supination. The only other significant finding was pain on active wrist extension against resistance. This reproduced her elbow pain. Neurovascular examination was normal. Roentgenograms of the right elbow revealed a large loose body with a defect in the distal capitellar articular surface. A zone of increased density was notable at the base of the crater-like defect. Flattening of the capitellum was demonstrable on the lateral view. Olecranon spurs were visible on both the AP and lateral views (Figures 1 and 2). Because of the presence of mechanical symptoms, limited range of motion, and loose body formation, surgery was indicated. Figure 1