Interpreting elbow radiographs in children

Accurate diagnosis of elbow fractures in children requires knowledge of anatomic development. The multiple ossification centers in the elbow can be mistaken for fractures, making radiographic diagnosis difficult. Anteroposterior and lateral radiographs are most commonly used, although oblique views may help in the detection of subtle injuries. Comparison views of the uninjured elbow are of questionable value. Anterior and posterior fat pad signs indicate joint effusion, which suggests significant trauma. Intersection of the anterior humeral and central radial lines can be used to assess joint alignment. Fractures displaced less than 2 mm are considered stable and may be treated conservatively.