Radiology X-Ray of Elbow and Forearm

Master the anterior-posterior (ap) position radiograph of the elbow and forearm, with the arm externally rotated, palm up, and full extension to reveal the distal humerus, radius, ulna, and epicondyles.

Align shoulder with elbow, place medial arm on table, turn hand palm toward the patient for a lateral elbow view with the medial epicondyle superimposed.

Explore the lateral elbow view's role in pediatric supracondylar and adult radial fractures. Learn how the anterior humeral line and radial capital line indicate pathology and radial head dislocation.

Assess the radial head view, also called the college view, projected largely to the ulna, to detect subtle cortex disruption and small radial head fractures.

Assess a trauma elbow X-ray showing sail sign with anterior fat pad elevation, indicating joint effusion and intra-articular radial head fracture; confirm non-displaced radial head fracture on radial head view.

Use the oblique view with lateral or external rotation to assess elbow fractures and dislocations, visualizing the radial head and neck, capitulum, coronoid process, and trochlea in profile.

Use the modified trauma projection when the elbow cannot fully extend; ab flexion view shows distal humerus in humeral parallel projection and proximal radius and ulna in forearm parallel projection.

Explore forearm views in radiology, including the anteroposterior view with radius and ulna in natural position, and the modified trauma lateral with a horizontal beam for minimal movement.

Explore the anatomy of the elbow and forearm, detailing the capitellum, humeral condyles, coronoid process, ulna, olecranon, trochlear notch, and the radius with its head, neck, and shaft.

Identify soft tissue abnormalities on elbow and forearm radiographs by noting anterior fat bed elevation or posterior fat bed elevation. Highlight elbow development and ossification center in pediatric cases.

The elbow comprises three joints—humeral ulnar, radial humeral, and proximal radial ulnar—featuring olecranon, coronoid process, trochlea, capitellum, and rotation of the radial head for pronation and supination.

Identify the ossification centers in pediatric elbows as they appear in sequence—from capitellum to radial head, medial epicondyle, trochlea, olecranon, then lateral epicondyle—visible on AP and lateral radiographs.

Learn the normal elbow x-ray anatomy, including the anterior fat pad, anterior humeral line, and radial line crossing the capitellum, plus the carrying angle.

Identify the fat pad sign on elbow x-rays as a marker of joint effusion from trauma, often signaling a radial head fracture in adults or a supracondylar fracture in children.

Assess elbow radiographs for posterior fat pad signs and a positive fat pad indicating intra-articular injury; a fat pad sign does not prove fracture.

Learn the fixed sequence of elbow ossification centers in children—capitellum, radial head, medial epicondyle, trochlea, olecranon, lateral epicondyle—and how this order guides fracture assessment.

Examine elbow variants such as the supracondylar spur (avian spur), supracondylar canal, and radial pseudocyst, and discuss their asymptomatic presentation and imaging approaches to distinguish benign variants from pathology.

Explore elbow and forearm trauma mechanisms, detailing fractures and dislocations such as supracondylar, radial head/neck, capitellum, olecranon, coronoid, distal humeral fractures, Galeazzi and Monteggia injuries, and the fat pad sign.

Learn the Mason classification of radial head and neck fractures from type I to IV, and recognize fat pad signs and Essex-Lopresti injuries requiring wrist imaging and MRI.

Explore Monteggia fracture dislocation, a proximal ulna fracture with radial head dislocation, its mechanisms, recognition pitfalls, radiocapitellar line, Bado classification types one through four, and reporting in forearm radiographs.

Identify Galeazzi fracture as a distal radius fracture with distal radioulnar joint dislocation. Assess the DRUJ direction (volar or dorsal) and note radial fracture location, angulation, and shortening.

The Galeazzi equivalent fracture features a radius fracture with distal ulnar growth-plate fracture while the distal radioulnar joint remains intact, often a type I Salter-Harris slipped epiphysis.

The supracondylar fracture of the distal humerus is the most common fracture, showing a transverse line across both condyles with anterior humeral line disruption and a posterior fat pad sign.

Explore pediatric lateral humeral condylar fractures, their Salter-Harris type distinctions (II and IV), displacement assessment, and fixation options via screw fixation when needed.

Identify medial epicondyle fractures as avulsion injuries with intra-articular entrapment and elbow dislocation. Note the trochlear ossification center appears after the medial epicondyle and compare with the contralateral elbow.

Identify osteochondral and capitellum injuries in elbow radiographs, including capitellum fractures, osteochondritis dissecans, and panner disease, using AP, lateral, and oblique views in adolescents.

Study olecranon fractures, including triceps insertion, displacement patterns, and intra-articular injuries. Recognize imaging signs on lateral views and differentiate avulsion, stress injuries, and calcification versus sociopathy.

Identify a rare coronoid fracture often as part of the terrible triad with posterior elbow dislocation and radial head fracture; lateral elbow radiography reveals a displaced, comminuted coronoid.

Explore distal humerus fractures and their subtypes, including supracondylar, transverse condyle, and intercondylar patterns, with type a extra-articular, type b intra-articular, and type c intra-articular involving both columns.

Explore nursemaid's elbow, where pulling a child's arm causes radial head subluxation under the annular ligament, treated by sequential forearm pronation and supination; diagnosis is clinical, with often normal x-rays.

Identify radial head dislocation by disruption of the radial-capitellum line and superior displacement of the radial head, with a small joint effusion and no gross fracture.

Learn to recognize posterior elbow dislocations and the terrible triad (radial head and coronoid fractures, especially in children), and emphasize repeat radiography after reduction to detect displaced or entrapped fragments.

Identify elbow osteoarthritis radiographically as primary or secondary, with joint-space narrowing, subchondral sclerosis, osteophytes, and subchondral cysts, often with loose bodies and olecranon bursitis.

Describe Little Leaguer elbow as medial epicondyle injuries in skeletally immature athletes from overhead sports, including avulsion fractures and chronic changes, with contralateral comparisons and associated Little Leaguer shoulder.

Explain golf and tennis elbow, with medial epicondylitis and lateral epicondylitis, and review radiologic findings such as capitellum osteochondral defects, radial pseudocysts, and congenital radioulnar synostosis.

Master elbow and forearm radiographs with ten quiz questions, identifying red arrows, coronoid process, supinator fat pad sign, monteggia fractures, supracondylar fracture, radial head fracture, and osteochondroma versus avian spur.