MR Imaging of Pediatric Elbow Trauma

Magnetic resonance imaging (MRI) of the pediatric elbow is important because it allows delineation of fracture type in a joint with complex anatomy, made more complex by the variable appearance of ossification centers of the distal humerus.1-4 Acute and chronic injuries can be evaluated with MRI using several classification systems. Accurate diagnosis of pediatric elbow trauma with MRI has management implications. For example, a Salter-Harris II fracture can be differentiated from a Salter-Harris IV physeal fracture by delineating intra-articular fracture extension and displacement, which requires open reduction internal fixation. The former is treated with closed reduction if nondisplaced, and the latter, with open reduction and internal fixation. The rate of complications in this age group is high and the treatment for these deformities thereafter can be difficult. There is also a useful role for MRI when the clinical history is unobtainable or absent as in a case of child abuse, for example. The multiplanar capability of MR allows for good preoperative planning to delineate fragment displacement. The main fracture classifications are presented.