Radial head fracture

Case contributed by A.Prof Frank Gaillard

Presentation

Fall onto out-stretched hands.

Patient Data

Age: 35 years
Gender: Male

Right elbow x-rays

Modality: X-ray

A sizable joint effusion indicates a probable fracture, most likely through the radial head.  The fracture itself is not clearly visualised.  Suggest re x ray in 7to 10 days.

Modality: Annotated image

The anterior fat pad sign, also known as sail sign or spinaker sign is the result of a joint effusion (yellow) elevating the normal anterior fat pad up and out of its normal location in the concavity of the humerus, which takes on a triangular shape (blue) on lateral projection.  

Right elbow x-rays - 10 days later

Modality: X-ray

Radial head fracture is now visible (best seen on oblique view) with a persistent small effusion. 

Modality: Annotated image

Persistent sail sign (blue). Cortical breach on the anterior aspect of the radial head is now visible. Articular fracture is presumably present but is undisplaced and occult.

Case Discussion

Importance of recognising a joint effusion as a marker of undisplaced radial head fracture. 

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Case Information

rID: 18084
Case created: 7th Jun 2012
Last edited: 9th Dec 2016
Inclusion in quiz mode: Included

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