The off-profile proximal radial epiphysis: another potential pitfall in the X-ray diagnosis of elbow trauma

If the elbow is filmed in flexion in a pubertal age child, the proximal radial epiphyseal line may be projected through the articular surface of the radial head on standard or oblique AP views. This can theoretically mimic a fissure or chisel-type fracture. Fractures involving the articular surface of the radial head, however, are extremely rare in children and the true fissure fractures that occur in the adult are notably different in specific radiographic features.