Lateral (left) and AP (right) radiographs of the left elbow | Figure 1

Cincinnati Children's Radiology

Lateral (left) and AP (right) radiographs of the left elbow in a 4-year-old after a fall show a non-displaced radial neck fracture (black arrows), likely Salter-Harris type 2 (i.e., metaphyseal to physeal fracture extension).  An intra-articular fracture of the olecranon is also noted (orange arrows). There is displacement of the anterior and posterior fat pads (white arrows) about the distal humerus, consistent with an associated joint effusion. Radial neck and olecranon fractures frequently occur simultaneously in children. #MSKMonday

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AP (image 1) and lateral (image 2) radiograph of the elbow shows radial and anterior displacement of the radius and ulna (arrow on image 1) and an avulsion fracture of the lateral condyle (arrow on image 2). En bloc displacement of the radius and ulna alerts the pediatric radiologist to the presence of distal humeral epiphyseal separation. This fracture is most commonly caused by a fall on an outstretched hand, hyperextensions, and rotation. It is important to recognize due to its strong association with nonaccidental trauma and the need for fixation by orthopedic surgery. On radiography, there is typically ulnar and posterior displacement of the radius and ulna. The images shown in this patient are atypical due to the radial and anterior displacement of the radius and ulna. #MSKMonday #MusculoskeletalMonday](https://app.figure1.com/case-detail/065445a0-7ca7-42bf-9ce1-6a7aab24a0c6)



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