This is a basic article for medical students and other non-radiologists
Elbow radiographs are common plain films that are obtained frequently in the emergency department.
Summary approach
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alignment
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drawn down the anterior surface of the humerus
should intersect the middle 1/3 of the capitellum
if it does not, think distal humeral fracture
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drawn along the radial neck
should always intersect the capitellum
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if it does not, think radial head dislocation or subluxation
check for an accompanying fracture, e.g. Monteggia fracture-dislocation
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effusion
visible posterior fat pad always indicates an elbow effusion
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if there is an effusion, think acute intra-articular fracture
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elbow fractures may be occult on x-rays
adult: radial head fracture
child: supracondylar fracture
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small anterior fat pad may be seen in normal patients
only significant if massively raised
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bones
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look specifically for common fractures
radial head and neck fractures
olecranon fracture
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cortex
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trace the cortex of each bone
distal humerus
radial head, neck and shaft
olecranon, coronoid process and ulnar shaft
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