Presentation
The patient fell from a bike and is experiencing pain in the left elbow along with swelling.
Patient Data
The left lateral elbow radiograph showed an elevated triangular shape in the anterior fat pad ("sail sign") and posterior fat pad, which indicates joint effusion.
The frontal radiograph showed a subtle radial head fracture.
Case Discussion
Elbow joint effusion is a good indicator to look for a fracture, and in the context of trauma, it’s typically a sign of an occult fracture.
The displacement of the anterior fat pad's triangular shape is referred to as the "sail sign." The anterior fat pad is normally visible as a thin line that parallels the distal humerus.
On the other hand, the posterior fat pad is typically invisible on lateral images. An elevated posterior fat pad indicates elbow joint effusion.
The radial head is the most common occult fracture in adults, whereas supracondylar fractures in children should be considered.
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