Posterior fat pad is elevated on the lateral view due to joint effusion. Supracondylar lucent line in the humerus can be seen on the frontal and oblique views.
Supracondylar fractures of the elbow are more common in pediatric population. Radial head and olecranon fractures are more common in adults.
If elbow joint effusion is found in a recent-trauma patient, occult elbow fracture is likely even when radiographs do not show one. Local practices after obtaining radiographs, which demonstrate elbow joint effusion vary, and can include:
- Immobilizing the elbow and obtaining repeat radiograph in a few days
- CT while patient is still in the ER. The drawback of immediate CT is that if the CT does not show a fracture line, there is still a small chance that a fracture may be present. Also, CT exposes patient to radiation, which is an issue, especially in pediatric population.
- MRI would be ideal to answer the question of presence or absence of occult fracture, but not many hospitals and urgent care centers can afford the luxury of 24×7 widely available MRI slots.