Department of Emergency Medicine

UMEM Educational Pearls

Title: Radiologic evaluation of the elbow (Part 2)

Category: Orthopedics

Keywords: Elbow, radiographs (PubMed Search)

Posted: 9/4/2010 by Brian Corwell, MD
Click here to contact Brian Corwell, MD

Radiologic evaluation of the elbow (Part 2)

Helpful clues in the evaluation of elbow trauma:

The Anterior humeral line and the Radiocapitellar line
- The anterior humeral line: On a true lateral film, this line is drawn along the anterior aspect of the humeral shaft on the lateral radiograph This line passes through the middle one third of the capitellum in bones that are not injured. It is very useful for detecting subtle fractures.
  - http://www.radiologyassistant.nl/images/thmb_4214e859138b1anthumlinebest.jpg
- Fractures (i.e. supracondylar) usually result in displacement of the capitellum posteriorly.
- Thus, the anterior humeral line passes through the anterior one third or entirely anterior to the capitellum.
  - http://www.imageinterpretation.co.uk/images/elbow/RAISED FAT PADS, SUPRACONDYLAR graphic.jpg
The Radiocapitellar line: Since the radius articulates with the capitellum, a line is drawn through the middle of the radius shaft and extended proximally through the joint should bisect the capitellum on all views (AP & lateral).
- http://img.medscape.com/pi/emed/ckb/radiology/336139-415822-5412.jpg
- http://nypemergency.org/images/v2c18n.jpg
- Improper alignment indicates a radial head dislocation (which may be very subtle)
  - http://nypemergency.org/images/mont.jpg
  - http://www.radiologyassistant.nl/images/49304bf192d7e12.jpg

References

http://www.radiologyassistant.nl/en/4214416a75d87

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