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Elbow XRay

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Elbow XRay, Sail Sign, Radiocapitellar Line

  • See Also
  1. Elbow Ossification Centers
  2. Radial Head Fracture
  • Views
  1. Standard Views
    1. Anteroposterior
    2. Lateral
      1. True lateral view with figure of 8 (distal humeral shaft and capitellum)
      2. Posterior olecranon fossa (posterior fat pad)
      3. Anterior coronoid fossa (anterior fat pad and Sail Sign)
  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. orthoElbowRadiocapitellarLine.jpg
    2. Line drawn longitudinally through center of proximal radius
    3. Line should bisect 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
  • Findings
  1. Distal Humerus Fracture
  2. Lateral Condyle Fracture
  3. Coronoid Process Fracture
  4. Supracondylar Fracture of Humerus
  5. Monteggia's Fracture
  6. Olecranon Fracture
  7. Radial Head Fracture
  8. Elbow Dislocation
  • Precautions
  1. Elbow Ossification Centers
    1. elbowOssificationCenters.jpg
    2. Consider when reviewing Elbow XRays in children
  • References
  1. Gharahbaghian in Herbert (2017) EM:Rap 17(11): 7-9