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Review
. 2017 Feb 20;9(1):7030.
doi: 10.4081/or.2017.7030.

Radiographic Evaluation of Common Pediatric Elbow Injuries

Steven F DeFroda  1 , Heather Hansen  2 , Joseph A Gil  1 , Ashraf H Hawari  3 , Aristides I Cruz Jr  2
Affiliations
Review

Radiographic Evaluation of Common Pediatric Elbow Injuries

Steven F DeFroda et al. Orthop Rev (Pavia). .

Abstract

Normal variations in anatomy in the skeletally immature patient may be mistaken for fracture or injury due to the presence of secondary centers of ossification. Variations in imaging exist from patient to patient based on sex, age, and may even vary from one extremity to the other on the same patient. Despite differences in the appearance of the bony anatomy of the elbow there are certain landmarks and relationships, which can help, distinguish normal from abnormal. We review common radiographic parameters and pitfalls associated in the evaluation of pediatric elbow imaging. We also review common clinical diagnoses in this population.

Keywords: Development; Elbow; Fracture; Pediatrics; Radiographs.

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Figures

Figure 1.
Figure 1.
Illustration of the pediatric elbow describing the normal appearance of the secondary ossification centers.
Figure 2.
Figure 2.
A) Monteggia fracture. White arrow represents ulnar bowing. The radial head is not directed at the capitellum. B) Lateral image more clearly demonstrates the malalignment of the radiocapitellar joint representing an associated posterior radiocapitellar dislocation.
Figure 3.
Figure 3.
Lateral x-ray of an extension type supracondylar humerus fracture. Note the anterior humeral line (black dotted line) passes far anterior to the capitellum rather than bisecting the anterior two-thirds.
Figure 4.
Figure 4.
A) Anteroposterior radiograph showing a lateral condyle fracture (white arrow). B) Lateral radiograph showing the typical posterior fragment associated with a lateral condyle fracture (white arrow).
Figure 5.
Figure 5.
A) Lateral radiograph showing an incarcerated medial epicondyle fracture (white arrow). B) Anteroposterior radiograph radiograph depicting the same (white arrow).
Figure 6.
Figure 6.
A) Anteroposterior radiograph showing a distal humeral physeal separation. Notice both the ulna and radius have translated together so the radial head still points towards the capitellum. B) Lateral x-ray depicting the mechanism of injury with the ulna translating posteriorly (black arrow) to the anterior humeral line (black dotted line) and the radial head maintaining its relationship to the capitellum (white dotted line).
See this image and copyright information in PMC

References

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