LAUSR

A four-year-old otherwise healthy girl presented to our outpatient clinic complaining of left elbow pain and swelling. The child’s parents reported an indoor trauma the previous day. On clinical examination, the left elbow and forearm exhibited diffuse swelling. The gentle passive range of elbow and forearm motion was normal and mostly pain-free. Nevertheless, the radial head was stable but a palpable click was noted. The neurovascular examination was normal. The patient received radiographs of the traumatized left and normal right elbow [Figures 1 and ​and2].2]. Radiographs of her left forearm were unremarkable. Open in a separate window Figure 1 Left elbow radiographs. (a) Two anterior-posterior projections of the left elbow. Note the presence of a well-ossified medial epicondyle epiphysis (red arrow) and simultaneous absence of the radial head epiphysis. Typically, the center of the radial head should ossify before that of the medial epicondyle. Notice the notched radial metaphysis (blue arrow). This notching is undetected in the other projection because of forearm rotation as indicated by radioulnar overlap. (b) Lateral view verifies the presence of well-ossified medial epicondyle epiphysis (red arrow) and simultaneous absence of the radial head epiphysis.