The Elbow

Normal anatomy | Fat pad sign | Anterior humeral line | Radiocapitellar line
Ossification centres | Radial head | Coronoid process | Supracondylar
Lateral condyle | Monteggia | Avulsion medial epicondyle | Pulled elbow


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Learning outcomes
  • Assess skeletal radiographs using a systematic approach
  • Use common lines which are helpful in interpreting the image
  • Describe elbow anatomy
  • Recognise and understand the significance of the fat pads
  • Understand mechanisms of injury and the likely fractures/dislocations which may result
  • Understand less common fractures around the elbow
  • Accurately describe dislocations and associated fractures
  • Understand how injury patterns differ in adults and children
  • Understand common eponyms
  • Identify normal paediatric anatomy and the development of secondary ossification centres
  • Recognise normal variants and their significance
Normal anatomy
Normal elbow
The fat pad sign
Normal (left), raised anterior fat pad (right)
Normal (left), raised posterior fat pad and fracture radial neck (right)
Anterior humeral line
Normal anterior humeral line
Abnormal anterior humeral line
Radiocapitellar line
Normal radiocapitellar line
Abnormal radiocapitellar line   Abnormal radiocapitellar line
Ossification centres
C = CAPITELLUM
R = RADIAL HEAD
I = INTERNAL EPICONDYLE (MEDIAL)
T = TROCHLEA
O = OLECRANON
L = LATERAL EPICONDYLE
Radial head fracture
By far the most common type of fracture in adults. May be subtle; a positive fat pad sign may be the only evidence. Radial head/neck fractures may be visible as either:
Radial head linear fracture
Radial neck fracture
Coronoid process fracture
Coronoid process fractures
Supracondylar fracture
Supracondylar fracture
Displaced supracondylar fracture   Displaced supracondylar fracture
Lateral condyle fracture
Lateral condyle fracture
Monteggia fracture-dislocation
Monteggia fracture-dislocation   Monteggia fracture-dislocation   Monteggia fracture-dislocation
Avulsion of the ossification centre for the internal (medial) epicondyle
Avulsion medial epicondyle
Pulled elbow

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