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Interpreting elbow radiographs in children

D S Fick1, T A Lyons

  • 1University of Iowa College of Medicine, Iowa City, USA.

American Family Physician
|March 1, 1997
PubMed
Summary

Diagnosing elbow fractures in children is challenging due to developing ossification centers. Radiographic assessment, including fat pad signs and alignment lines, aids in identifying injuries and determining conservative treatment for stable fractures.

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Area of Science:

  • Pediatric Orthopedics
  • Radiology
  • Pediatric Trauma

Background:

  • Elbow fractures in children present diagnostic challenges due to evolving anatomy and multiple ossification centers.
  • Radiographic interpretation requires understanding normal developmental variations to avoid misdiagnosis.

Purpose of the Study:

  • To review the radiographic diagnosis of elbow fractures in pediatric patients.
  • To highlight key imaging findings and assessment methods for accurate diagnosis.

Main Methods:

  • Review of anteroposterior (AP) and lateral radiographs, with consideration for oblique views.
  • Evaluation of anterior and posterior fat pad signs for joint effusion.
  • Assessment of joint alignment using the intersection of anterior humeral and central radial lines.

Main Results:

  • Multiple ossification centers can mimic fractures, complicating diagnosis.
  • Anterior and posterior fat pad signs suggest significant trauma and joint effusion.
  • Fractures with displacement < 2 mm are generally considered stable.

Conclusions:

  • Accurate diagnosis relies on understanding pediatric elbow anatomy and development.
  • Specific radiographic signs (fat pads, alignment lines) are crucial for identifying elbow injuries.
  • Conservative management is appropriate for stable pediatric elbow fractures with minimal displacement.

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