Elbow MSK ultrasound in children with radial subluxation

Abnormal MSK ultrasound findings of the elbow posterior fat pad in children with radial head subluxation

In radial head subluxations (RHS), which is one of the most common elbow injuries in children, the annular ligament slips into the radiohumeral articular space. History taking and physical examination are often not sufficient to differentiate RHS from elbow fractures. However, MSK ultrasound provides the possibility to detect an elevated posterior fat pad (PFP) or lipohemarthrosis of the PFP, findings that are highly sensitive for fracture at the elbow. It is not clear though whether the same findings are also present in children with RHS. 

The authors found that in the majority of children with RHS (83%), the MSK ultrasound findings were normal. Only 17 % of the children tested had a minimally elevated elbow PFP. Thus, elevated elbow PFP and lipohemarthrosis can be possible findings in children with RHS, but normal MSK ultrasound findings may encourage the clinician’s choice for reduction of the RHS. The use of MSK ultrasound might consequently also decrease the number of unnecessary radiographs.

> From: Rabiner et al., Pediatr Emerg Care 31 (2015-05-21 21:56:25) 1-5 . All rights reserved to Wolters Kluwer Health, Inc. Click here for the online summary.

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