|Patient: 2 year 1 month old female|
|History: Patient presents with a tender elbow after falling on an outstreched hand.|
|Findings: No fracture is visible on X-ray. The lateral view demonstrates elevation of the anterior and posterior fat pads. Remember, even if a fracture cannot be visualized on a radiograph, the fat-pad sign suggests the presence of an occult fracture. Follow up radiographs with an oblique view should be suggested.|
|Diagnosis: Positive fat-pad sign with displacement of the anterior and posterior fat pads. Also there is displacement of the anterior humeral line consistent with a supracondylar fracture.|
| Discussion: |
With subtle elbow fracture the value of soft tissue swelling and the anterior humeral line cannot be stressed enough. The presence or absence of the fat-pad sign should always be assessed. With a history of trauma a fracture should always be considered with a positive fat-pad sign. Elevation and displacement of the fat pads denotes fluid in the joint, obliteration denotes periarticular edema and swelling. Both anterior and posterior fat pads can be displaced. Unlike the anterior fat pad, the posterior fat pad is not normally visible, thus if it is visible it is displaced. The fat pads can be hazy or obliterated due to edema around the elbow.
| References: |
Swischuk, Leonard E., M.D. Emergency Imaging of the Acutely Ill or Injured Child, 3rd ed. Baltimore: Williams & Wilkins, 1994.
| Comments: |
No comments posted.
| Additional Details:|
Case Number: 472566Last Updated: 06-01-2004 The reader is fully responsible for confirming the accuracy of this content.
The reader is fully responsible for confirming the accuracy of this content.