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Radial neck fracture and sail sign

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

30 year old woman fell of a push-bike onto the left elbow.

Patient Data

Age: 30 years
Gender: Female

X-rays of the left elbow demonstrate a prominent anterior fat pad (sail sign) with the posterior fat pad also visible. This is consistent with a large joint effusion.

No definite fracture can be seen, although the radial head appears a little ill-defined laterally. This is the most common site of fracture in this scenario.

Repeat x-rays one week later

x-ray

Note the thin ill-defined sclerotic line across the neck of the radius.

Case Discussion

This case illustrates the utility of repeat x-rays in the setting of suspected but radiographically occult fracture. 

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