Radial head fracture
Fall while drunk. Now painful elbow.
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There is a mildly displaced intra-articular fracture of the radial head, with a ~2mm articular step-off. Joint effusion noted.
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Even when a fracture is invisible, a large elbow joint effusion in an adult, should be treated as a radial head fracture. In this case the fracture is evident, and will probably require ORIF.