Supracondylar fracture with posterior fat pad and sail signs

Case contributed by Dr Afra Alfalahi

Presentation

History of trauma

Patient Data

Age: 3 years
Gender: Female

Lateral elbow radiograph shows cortical disruption of the anterior aspect of the supracondylar right humerus. Posteriorly in the olecranon fossa, the soft tissue density is reduced (fat like density) and anteriorly the anterior fat pad is displaced superiorly. 

On annotated image lateral view: Positive posterior fat pad sign as indicated by yellow line in the olecranon fossa. This is not seen on normal elbow radiographs. 

The positive sail sign is highlighted in red, the latter represents superior displacement of the anterior fat pad. 

Both of these findings are caused by joint effusion associated with elbow joint fracture and can help identify an occult fracture (although the fracture can be seen in this case).

Case Discussion

On annotated image lateral view: Positive posterior fat pad sign as indicated by yellow line in the olecranon fossa. This is not seen on normal elbow radiographs.

The positive sail sign is highlighted in red, the latter represents superior displacement of the anterior fat pad.

Both of these findings are caused by joint effusion associated with elbow joint fracture and can help identify an occult fracture (although the fracture can be seen in this case).

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Case information

rID: 54689
Case created: 23rd Jul 2017
Last edited: 21st Nov 2017
Inclusion in quiz mode: Excluded

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