Elbow Imaging

Question 1

Suspecting a radial head/neck #, what’s another further image that could be requested ?

Answer 1

Couple’s or radial head view

Question 2

List the order of appearance of ossification centres at the elbow and their age of each

Answer 2

1. Capitulum - age 1
2. Radial head - age 3
3. Internal medial condyle - age 5
4. Trochlea - age 7
5. Olecranon - age 9
6. External lateral epicondyle - age 11

Question 3

What is the acronym for the ossification centres at the elbow in order ?

Answer 3

C apitulum

R adial head

I nternal medial condyle

T rochlea

O lecranon

E xternal lateral epicondyle

Question 4

What are your 4 key areas to look for in the alignment of an elbow X-ray?

Answer 4

1. The joint space is open
2. Both epicondyle are visible
3. Olecranon is in the fossa
4. Radial head, neck overlap with ulnar

5 the radiocapitellar line should bisect capitellum on all views

Question 5

If the radiocapitellar line does not bisect the capitellum, what could this indicate

Answer 5

Dislocation

Question 6

How do we check alignment on an oblique elbow X-ray? (1)

Answer 6

Radial head, neck and bicipital tuberosity should not be overlapping ulna

Question 7

On a lateral elbow X-ray, what is the anterior humeral line and what does it indicate ?

Answer 7

Bisection of the humeral shift through the anterior 1/3 and posterior 2/3 capitulum

It is used to look at supracondylar fractures

Question 8

What could be indicated if the anterior fat pad is raise and/or posterior fat pad is visible?

Answer 8

An intra articular fracture

Question 9

What’s more common fracture in paediatric, radial neck or supracondylar ?

Answer 9

Supracondylar

Question 10

How do we evaluate alignment at the forearm x-ray? (4)

Answer 10

1. Epicondyle visible in profile
2. Radial head, neck and bicipital tub. Slightly overlapping ulna
3. Elbow and wrist partly open
4. Radius should point to capitellum

Question 11

Radius should do what in ALL views on elbow and forearm x-rays ?

Answer 11

Draw direct line to capitellum

Question 12

What is a key distinction between forearm and elbow x-rays

Answer 12

On an elbow x-ray the radiocapitellar jt space is well visualised

Question 13

The Gartland classification of supracondylar fractures is based on what?

Answer 13

The anterior humeral line, has grades 1-3

Question 14

What are your two common fracture/dislocations at the elbow

Answer 14

Monteggia

Galleazzi

Question 15

What is a monteggia #

Answer 15

Dislocated radius and fractured ulnar

Question 16

What is a Galleazzi #

Answer 16

Dislocated distal ulnar and radial fracture