Radial head occult fracture

Case contributed by Mohamed El Deen

Presentation

Trauma to the right elbow two days ago with localized pain on the lateral aspect of the joint.

Patient Data

Age: 43
Gender: Female
x-ray

Some times it is difficult to distinguish occult radial head fractures in radiography. Presence of elevated anterior fat pad  "sail sign" in lateral projection is highly suspicious for the presence of an occult fracture. Osteoarthritic changes in the elbow joint are also noted.  

ct

CT scan axial, sagittal, coronal and 3D reformat showing occult fissure fracture of radial head and neck . Marginal osteophytes from DJD changes are also noted in joint bones.

Case Discussion

Some times it is difficult to distinguish occult radial head fractures in radiography. The presence of an elevated anterior fat pad  "sail sign" in the lateral projection is highly suspicious for the presence of an occult fracture.

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