Retinoic acid arthropathy typically presents in the axial skeleton as flowing ossification along the anterior longitudinal ligament and as a condition of pelvic hyperostosis. When the appendicular skeleton is involved, radiographic findings usually present late and are typically asymmetric. We present an unusual case of retinoic acid arthropathy presenting in both elbow joints. Radiologists should consider this diagnosis when faced with hyperostosis that is not explained by sports-related history.