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MDCT of the Elbow in Pediatric Patients with Posttraumatic Elbow Effusions

Vernon Chapman1,2, Brian Grottkau3, Maurice Albright3, Ahmed Elaini3, Elkan Halpern3 and Diego Jaramillo4

1 The Children's Hospital of Denver, 7136 S Hudson Ct., Centennial, CO 80122.
2 Massachusetts General Hospital for Children, Boston, MA.
3 Radiology Imaging Associates, Englewood, CO.
4 Children's Hospital of Philadelphia, Philadelphia, PA.


Figure 1
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  		Fig. 1A —10-year-old boy with left elbow pain after falling down stairs. Lateral radiograph of elbow shows fat pad sign with elevation of anterior and posterior fat pads (arrows). No fracture was identified on frontal or lateral radiographs of elbow.

 

Figure 2
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  		Fig. 1B —10-year-old boy with left elbow pain after falling down stairs. Axial MDCT image through level of distal humerus confirms presence of joint effusion (arrows).

 

Figure 3
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  		Fig. 1C —10-year-old boy with left elbow pain after falling down stairs. Sagittal (C) and coronal (D) reformatted images show nondisplaced supracondylar fracture (arrow).

 

Figure 4
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  		Fig. 1D —10-year-old boy with left elbow pain after falling down stairs. Sagittal (C) and coronal (D) reformatted images show nondisplaced supracondylar fracture (arrow).

 

Figure 5
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  		Fig. 2A —3-year-old girl with left elbow pain after wrestling. Lateral radiograph of elbow shows fat pad sign with elevation of anterior and posterior fat pads (arrows). No fracture was identified on frontal or lateral radiographs of elbow.

 

Figure 6
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  		Fig. 2B —3-year-old girl with left elbow pain after wrestling. Coronal reformatted MDCT image shows fracture (arrow) of lateral condylar of distal humerus with less than 2-mm displacement of fracture fragments. Patient was treated nonoperatively, and fracture healed without complication.

 

Figure 7
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  		Fig. 3A —15-year-old boy with left elbow pain after falling off bicycle. Lateral radiograph of elbow shows fat pad sign with elevation of anterior and posterior fat pads (arrows). No fracture was identified on frontal or lateral radiographs of elbow.

 

Figure 8
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  		Fig. 3B —15-year-old boy with left elbow pain after falling off bicycle. Axial (B) and coronal (C) reformatted MDCT images show nondisplaced fracture (arrow) of radial head.

 

Figure 9
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  		Fig. 3C —15-year-old boy with left elbow pain after falling off bicycle. Axial (B) and coronal (C) reformatted MDCT images show nondisplaced fracture (arrow) of radial head.

 

Figure 10
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  		Fig. 4A —7-year-old girl with left elbow pain after falling out of chair. Lateral radiograph of elbow shows fat pad sign with elevation of anterior and posterior fat pads (arrows). No fracture was identified on frontal or lateral radiographs of elbow.

 

Figure 11
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  		Fig. 4B —7-year-old girl with left elbow pain after falling out of chair. Sagittal reformatted MDCT image shows nondisplaced Salter type 2 fracture (arrow) of radial neck. Follow-up radiographs obtained 2 weeks after injury showed no evidence of healing fracture.

 

Figure 12
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  		Fig. 5A —3-year-old boy with right elbow swelling after fall. Lateral radiograph of elbow shows fat pad sign with elevation of anterior and posterior fat pads (arrows). No fracture was identified on frontal or lateral radiographs of elbow.

 

Figure 13
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  		Fig. 5B —3-year-old boy with right elbow swelling after fall. Axial (B) and coronal oblique (C) reformatted MDCT images show nondisplaced fracture (arrows) of proximal ulna. Follow-up radiographs obtained 3 weeks after injury showed no evidence of healing fracture.

 

Figure 14
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  		Fig. 5C —3-year-old boy with right elbow swelling after fall. Axial (B) and coronal oblique (C) reformatted MDCT images show nondisplaced fracture (arrows) of proximal ulna. Follow-up radiographs obtained 3 weeks after injury showed no evidence of healing fracture.

 

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