Step by Step Approach to Interpretation of Pediatric Elbow Radiography

Trauma to the pediatric’s elbow are common and may result in different types of injuries such as bony, cartilaginous or soft tissue injuries. Fall on an outstretched hand is the most common mechanism of injury that mostly may result in hyperextension or valgus load to the elbow [1,2]. Comparing with adults, pediatric elbow fractures have a higher incidence and variability in fracture patterns [3]. 65 to 75% of all pediatric fractures are related to upper extremity. The most common is supracondylar humerus fracture followed by lateral condyle and medial epicondyle fractures [4]. Interpretation of pediatric elbow radiography needs a systematic approach to prevent misdiagnosis. In this study we explained a six-steps approach to an elbow radiography for better diagnosis of the injury. The quality of radiography, identification of the presence and position of ossification centers, a search for effusion and localized soft tissue swelling, check the alignments, check the bone cortices and finally a focused search to avoid common mistakes based on the history and clinical examination of the patient are discussed in details.