Presentation
Fall from monkey bars. Unable to straighten arm.
Patient Data
The lateral film demonstrates a small joint effusion but it is not until the oblique film (unintentionally oblique and actually performed as the first film of the study) that we see an irregularity to the anterior cortex of the capitellum.
As demonstrated on the plain-flim, there is an oblique fracture through the lateral portion of the capitellum.
The oblique fracture through the capitellum is clearly demonstrated on the CT.
Case Discussion
Fracture of the capitellum is not a common injury in the pediatric population, but may occur where there is direct trauma to the medial distal humerus.
This was picked up on the oblique radiograph performed at the time of injury. The obliquity was unintentional but it highlights the importance of always looking at all the imaging that is available at the time of reading the study.