Proximal radio-ulnar synostosis

Case contributed by Mohamed El Deen
Diagnosis almost certain

Presentation

Came to the ER department with left elbow deformity since 3 months after falling down at home, by clinical examination there is an inability to rotate the left elbow beyond 10 degrees of supination.

Patient Data

Age: 5 years
Gender: Female
x-ray

Plain radiographic images in (AP, LAT) views showing complete synostosis has occurred, with the proximal radius and ulna of the left forearm, involving the radial head. 

Case Discussion

Proximal radio-ulnar synostosis was discovered incidentally. By clinical examination there was inability to rotate the left elbow beyond 10 degrees of supination.

Radioulnar synostosis is one of the most common defects of separation of parts of the upper limb. Some cases are genetically transmitted. It is often not noted until late childhood or incidentally in post-traumatic X-rays. This is because the joint function may be normal, especially in unilateral cases or increased wrist motion which may compensate for the absent forearm motion.

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