Stress reactions in the upper limb are relatively rare. Usually stress reactions are caused by traction of muscles on the periosteum or by maladaptation of the bone due to repetitive strain. They are common in the lower extremity, mainly in the distal tibia and in the second metatarsal. Maarten Moen and Adam Weir reviewed the following article: Lee JC, Malara FA, Wood T, Hoy G, Saifuddin A, Connell DA. Magnetic Resonance Imaging (MRI) of stress reaction of the distal humerus in elite tennis players. Am J Roentgenol 2006;187: 901-904 This article describes stress reaction in the humerus on MRI in players who participated at the Australian Open Tennis Championships and has never been described before. The players complained of pain in the middle to distal part of the humerus during serving and after the match. On physical examination, pain was present along the medial supracondylar ridge, the lateral supracondylar ridge or the posterior distal humerus.
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