Hypertrophy of the Annular Ligament as a Cause of Painful Elbow Snapping: Case Report and Literature Review.

Snapping annular ligament is an uncommon cause of lateral elbow pain. Due to the limited literature, snapping annular ligament is often misdiagnosed as lateral epicondylitis. Recognition of this uncommon condition is important as early surgical intervention is recommended to prevent erosion of articular cartilage caused by the hypertrophic synovial fold and early-onset arthritis. We present a 37-year-old male with left lateral elbow pain and clicking for 5 years. MRI of the elbow revealed hypertrophy of the annular ligament with associated lateral epicondylitis. After failing conservative management, the patient underwent open resection of the hypertrophied annular ligament in addition to lateral epicondylitis surgery. The patient demonstrated complete relief of symptoms. Our aim is to increase the nurse's and hand surgeon's awareness of hypertrophy of the annular ligament as an uncommon cause of lateral elbow snapping and pain. We also review the literature, pathophysiology, nursing and surgical management and outcomes of treatment for this rare condition.