Abstract
The evaluation of X-rays of the paediatric elbow in the setting of trauma is challenging. The difficulty arises from the complex developmental anatomy of the elbow, with its multiple ossification centres and the differences in the pattern of injuries between adults and children. It is essential to evaluate the radiographs systematically. This review will provide an overview of the developmental anatomy, the range of soft tissue and skeletal findings, and demonstrate tips and pitfalls in radiographic interpretation in paediatric elbow trauma.
Highlights
For the true lateral projection, the elbow should be flexed 90 degrees with the forearm supinated (Figure 2)
On a true lateral radiograph with 90 degrees of flexion the normal anterior fat pad is within the coronoid fossa and is seen as a radiolucent line parallel to the anterior humeral cortex; the posterior fat pad is pressed deep into the olecranon fossa by the triceps tendon and the anconeus muscle and is invisible.[8]
More recent studies looking at MRI and MDCT show occult fractures in the majority of patients, a b they do stress that these investigations did not significantly alter management.[10,11]
Summary
For the true lateral projection, the elbow should be flexed 90 degrees with the forearm supinated (Figure 2). The internal oblique view is useful in the demonstration of lateral condyle fractures and in assessing the degree of displacement.[2] On a true lateral radiograph with 90 degrees of flexion the normal anterior fat pad is within the coronoid fossa and is seen as a radiolucent line parallel to the anterior humeral cortex; the posterior fat pad is pressed deep into the olecranon fossa by the triceps tendon and the anconeus muscle and is invisible.[8] Distention http://www.sajr.org.za doi:10.4102/sajr.v19i2.881
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