It is important to assess the radiograph for a joint effusion and where one exists, to take extra care in the assessment of the radial head. Even when a fracture cannot be identified, the presence of joint effusion in adults should be treated as a non-displaced radial head fracture.Įlbow effusions are best appreciated on a lateral projection, where fluid in the joint capsule elevates the pericapsular fat, seen as anterior or posterior fat pad sign. Radial head fractures can be subtle and easily missed on radiographs. When a fracture is not seen but there is clinical suspicion, a Coyle's view can be performed.
The elbow is typically radiographed in AP and lateral projections, although an external oblique view is very frequently also obtained to better visualize the radial head. The Mason-Johnston classification can be used to further classify radial head fractures, although, in practice, most radiologists merely describe the injury. Triangular fibrocartilage complex injury at the wrist ( Essex-Lopresti fracture-dislocation)
While the majority of radial head fractures are isolated, a number of other injuries may also be seen 2:įracture of the coronoid process of the ulna A direct blow to the elbow can cause a radial head fracture but is uncommon. In practice, the history is often a fall onto an outstretched arm. Radial head fractures usually occur as a result of indirect trauma, with most resulting from a fall on an abducted arm with minimal or moderate flexion of the elbow joint (0 - 80°) 2. This results in valgus pronation stress with the radial head forcibly pushed against the capitulum of the humerus 1,2. Although fractures of the radial head are seen in all age groups, they usually occur in adults (85% between 20-60 years of age) and more frequently in women (M: F 1:2) 2.
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