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A 5 year old presents with FOOSH injury and a swollen elbow. His elbow x-rays are as follows. What do you notice?
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[peekaboo_link name=”Answer”]Answer[/peekaboo_link]
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The AP view shows no obvious fracture and the radiocapitellar line is intact.
However, the lateral view shows the ‘sail sign’; the anterior humeral line has the entire capitulum lying in front of it. This should raise the possibility of a supracondylar fracture. If you look carefully, there is a supracondylar fracture with volar angulation of the distal humerus.
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More details on fat pad sign and anterior humeral lines can be found at:
http://www.emergucate.com/2012/10/08/imaging-case-of-the-week-16/
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