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Case Reports
. 2024 Oct 18;16(10):e71801.
doi: 10.7759/cureus.71801. eCollection 2024 Oct.

Upper Extremity Pseudoparalysis: A Case Report of Bilateral Nursemaid's Elbows

Alexander R Orta  1 , Guo Qian  2 , Andrew S Outlaw  3
Affiliations
Case Reports

Upper Extremity Pseudoparalysis: A Case Report of Bilateral Nursemaid's Elbows

Alexander R Orta et al. Cureus. .

Abstract

Radial head subluxation (RHS), commonly known as 'nursemaid's elbow,' typically presents in pediatric patients with acute-onset unilateral arm pain and pseudoparalysis. The classic mechanism of injury involves a longitudinal traction force pulling the radial head through the annular ligament. Bilateral RHS is exceedingly rare, with only a few cases documented in the literature; notably, all cases with a provided history and physical exam presented with the classic mechanism of injury, aiding in diagnosis and treatment. Here, we report the case of a two-year-old male with bilateral RHS who presented to the emergency department with bilateral upper extremity pain and weakness following an unwitnessed injury. This case required a broad differential diagnosis, including musculoskeletal injury, central cord syndrome, and spinal cord injury without radiographic abnormality (SCIWORA). It underscores the importance of considering RHS in differential diagnoses, even in atypical presentations, to ensure prompt and effective management.

Keywords: atypical presentation; bilateral radial head subluxation; central cord syndrome; nursemaid's elbow; pediatric emergency medicine; pediatric musculoskeletal injury; pseudoparalysis; radial head subluxation; sciwora.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Chest and forearm plain radiographs.
Chest AP view (1A, top left); chest lateral view (1B, top right); forearms lateral view (1C, bottom center).
Figure 2
Figure 2. Elbows and humeri plain radiographs.
Right elbow lateral view (2A, top left); Left elbow lateral view (2B, top right); Right humerus lateral view (2C, bottom left); Left humerus lateral view (2D, bottom right).
See this image and copyright information in PMC

References

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