Elbow series

Last revised by Tariq Walizai on 21 Jun 2024

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

Cases and figures

  • Figure 1: elbow series
  • Figure 2: coyle's view
  • Figure 3: acute flexion AP view (distal humerus)
  • Figure 4: acute flexion AP view (proximal forearm)
  • Figure 5: internal oblique view
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