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Elbow fat pad sign: implications for clinical management
A C de Beaux1, T Beattie, F Gilbert
1Accident and Emergency Department, Aberdeen Royal Infirmary, Foresterhill, UK.
Journal of the Royal College of Surgeons of Edinburgh
|June 1, 1992
Summary
The fat pad sign in elbow injuries can indicate joint swelling. Repeat X-rays are often unnecessary, as most fractures are not found upon follow-up after trauma.
Area of Science:
- Orthopedic surgery
- Radiology
- Trauma care
Background:
- The fat pad sign on elbow X-rays suggests joint effusion after trauma.
- Its clinical significance, especially when no fracture is visible, is debated.
- The necessity of routine follow-up radiography is questioned.
Purpose of the Study:
- To evaluate the utility of routine repeat radiography for elbow injuries.
- To determine the incidence of occult fractures after a positive fat pad sign.
- To assess the clinical outcomes of patients with elbow effusion and no visible fracture.
Main Methods:
- Retrospective analysis of 45 cases with elbow trauma and a positive fat pad sign.
- Review of initial and follow-up radiographs.
- Assessment of clinical outcomes at 2-week review.
Main Results:
- 6% incidence of fracture on repeat radiography.
- 29 out of 45 cases had normal repeat radiographs.
- Most patients with a positive fat pad sign and no initial fracture were clinically well.
Conclusions:
- Routine repeat radiography is not necessary for elbow injuries with a positive fat pad sign and no visible fracture.
- The fat pad sign alone does not warrant mandatory follow-up imaging.
- Clinical assessment is often sufficient in managing these cases.