Congenital radial head dislocation

Case contributed by Salman S. Albakheet
Diagnosis certain

Presentation

Painless reduced range of extension and forearm rotation with prominence seen in lateral aspect of elbow . There is no history of trauma.

Patient Data

Age: 14 months
Gender: Female

Anterior lateral dislocation of the radial head with a domed articular surface. There is malalignment of the radiocapitellar line. The radius is relatively longer in relation to ulna. 

Case Discussion

Congenital dislocation of the radial head is the most common congenital elbow abnormality and in the majority of cases it is bilateral. Usually occurs in association with other conditions (60% of the time), but can also occur in isolation. Associations include:

  • Apert's Syndrome
  • Klinefelter's Syndrome
  • Cornelia de Lange Syndrome
  • Ehler's-Danlos Syndrome
  • Nail-patella syndrome

The main differential is that of traumatic radial head dislocation and can differentiated by :

  • bilateral involvement
  • hypoplastic capitellum
  • convex radial head
  • other congenital anomalies
  • lack of history of trauma
  • difficult to reduce

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