Radial head fracture

Case contributed by Dr Derek Smith

Presentation

Fall off bike. Tender around left elbow, limited range of movement.

Patient Data

Age: 30 years
Gender: Female

Presentation imaging

X-ray

No definite bony injury, but there is an elevated fat pad which is highly suspicious for a radial head fracture.

Joined images

X-ray

Anterior effusion suggesting occult radial head fracture.

Follow-up imaging (six weeks later)

X-ray

The anterior effusion has resolved, but on the frontal projection a minimally displaced radial head fracture is evident.

Case Discussion

Radial head fractures are relatively common injuries, typically after indirect trauma to the elbow, for example a fall.

An effusion is often the sign that there is an undisplaced fracture, as fluid in the joint capsule elevates the fat pad.

This can be seen even without an obvious fracture so is an important area to review. This case was recalled for further imaging due to ongoing pain and shows a clear fracture at the radial head which was not appreciable on the original imaging.

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