Asymptomatic fatigue fracture of the proximal ulna associated with symptomatic fatigue fractures of the lower limbs

Fatigue fractures usually involve the lower extremities after unaccustomed or inappropriate exercise. Although unusual in the upper extremity, symptomatic fatigue fractures of the ulna have been described in tennis players, volleyball players, weight lifters, and softball pitchers. The mechanism is thought to be due to overuse of the flexor muscles, with subsequent loss of mechanical integrity of the proximal ulna. The following case is representative of four similar cases of soldiers with asymptomatic fatigue fractures of the ulna shown by whole-body bone scintigraphy performed to evaluate lower limb pain.