A retrospective case-control study was undertaken to evaluate the pathologic radiographic changes that occur in primary osteoarthritis of the elbow. The radiographs of 50 patients with primary osteoarthritis of the elbow were compared with an age- and sex-matched control group to distinguish those features specific to elbow osteoarthritis from those occurring as a result of normal aging. We assessed 100 radiographs (50 anteroposterior and 50 lateral views) in both the study and control groups for 10 radiographic features. In the osteoarthritic group, osteophytes of the olecranon (96%), coronoid process (90%), radial head (86%), and coronoid and radial fossae (64%) were the most frequent findings. Joint space narrowing occurred predominantly at the radiocapitellar joint (58%) and was more common than at the ulnotrochlear joint (16%). Thickening of the olecranon fossa membrane was noted in 68%. In the age- and sex-matched control group, coronoid osteophytes occurred in 36% of cases, but the other features were rarely observed.
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