Elbow series

Last revised by Andrew Murphy on 23 Mar 2023

The elbow series is a set of radiographs taken to investigate elbow joint pathology, often in the context of trauma. It usually comprises an AP and lateral projection, although other non-standard, modified projections are utilized for specific indications.

Indications

Elbow x-rays are indicated for a variety of settings including:

  • trauma
  • bony tenderness
  • suspected fracture of the proximal radius and ulna
  • suspected fracture of the distal humerus
  • radial head dislocations
  • obvious deformity
  • detecting joint effusions
  • arthritis
  • infection

Projections

Standard projections
  • AP
    • demonstrates distal humerus, proximal ulna, and radius
    • shows both the medial and lateral epicondyles in profile
  • lateral
Modified trauma projections
  • horizontal beam lateral
    • modified lateral projection that requires little to no patient movement
    • produces a diagnostic lateral/AP projection without risking patient pain
  • acute flexion AP
    • modified AP projection when the patient cannot straighten the arm 
  • inferosuperior view
    • modified elbow projection for patients in acute flexion greater than 90 degrees
Additional projections
  • Coyle's view
    • an axial projection that focuses on the radial head, used when radial head fractures are suspected 
  • external oblique
    • an additional projection often performed to demonstrate the radial head free from superimposition
  • internal oblique view
    • projection demonstrating the coronoid process in profile 
  • supracondylar AP

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