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Elbow XRay

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Elbow XRay, Sail Sign

  • See Also
  1. Elbow Ossification Centers
  • Views
  1. Standard Views
    1. Anteroposterior
    2. Lateral
  2. Special views
    1. Radial Head-Capitellum View
      1. Isolates radial head without overlapping shadows
  • Technique
  1. Elbow in 90 degree flexion
  2. Compare with opposite elbow
  • Evaluation
  • Landmarks on lateral Elbow XRay
  1. Anterior humeral line
    1. Line drawn along the anterior edge of the Humerus
    2. Passes through middle third of the capitellum
  2. Radiocapitellar line
    1. Line drawn through center of radius
    2. Normally bisects the capitellum
  • Evaluation
  • Findings suggestive of Fracture
  1. Sail Sign (effusion displaces the anterior fat pad)
    1. Consider Radial Head Fracture
    2. May also represent synovitis or spontaneous hemarthrosis without Fracture
  2. Posterior fat pad sign (always pathologic)
    1. Child: Supracondylar Fracture
    2. Adult: Radial Head Fracture
  • Precautions
  1. Elbow Ossification Centers need to be considered when reviewing Elbow XRays in children
  • References
  1. Gharahbaghian in Herbert (2017) EM:Rap 17(11): 7-9