Occult fracture of radial head

Case contributed by Dileep Raj Janardhan
Diagnosis certain

Presentation

This patient presented with a history of slip and fall, followed by severe elbow pain on supination-pronation movements.

Patient Data

Age: 30 years
Gender: Male
x-ray
Lateral
Frontal
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Info

The lateral radiograph of the involved elbow shows a positive sail sign:

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CT sagittal images show a non-displaced extra-articular hairline fracture along the anterior aspect of the head of radius, seen as subtle cortical stepping and focal loss of trabecular continuity.

Case Discussion

This patient presented with a history of slip and fall, followed by severe elbow pain on supination-pronation movements.

The lateral radiograph of the involved elbow shows a positive sail sign:

  • elevation of the anterior fat pad of the elbow

  • visible and elevated (normally non-visualised) posterior fat pad of elbow

CT sagittal images shows a non-displaced extra articular hairline fracture along the anterior aspect of the head of radius seen as subtle cortical stepping and focal loss of trabecular continuity.

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