This is a basic article for medical students and other non-radiologists
Elbow radiographs are common plain films that are obtained frequently in the emergency department.
Summary approach
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alignment
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anterior humeral line
- drawn down the anterior surface of the humerus
- should intersect the middle 1/3 of the capitellum
- if it does not, think distal humeral fracture
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radiocapitellar line
- drawn along the radial neck
- should always intersect the capitellum
- if it does not, think radial head dislocation or subluxation
- check for an accompanying fracture, e.g. Monteggia fracture-dislocation
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anterior humeral line
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effusion
- visible posterior fat pad always indicates an elbow effusion
- if there is an effusion, think acute intra-articular fracture
- elbow fractures may be occult on x-rays
- adult: radial head fracture
- child: supracondylar fracture
- elbow fractures may be occult on x-rays
- small anterior fat pad may be seen in normal patients
- only significant if massively raised
-
bones
-
look specifically for common fractures
- radial head and neck fractures
- olecranon fracture
-
look specifically for common fractures
-
cortex
- trace the cortex of each bone
- distal humerus
- radial head, neck and shaft
- olecranon, coronoid process and ulnar shaft
- trace the cortex of each bone