Occult Elbow

Skaggs DL Mirzayan R (1999) The posterior fat pad sign in association with occult fracture of the elbow in children. 

Fig. 8.74a-d. Occult fracture of the right coronoid process in a woman following a ski accident, a The patient had a negative radiographic examination performed soon after the injury, b Two weeks later, she was submitted to US examination due to persistent elbow pain and loss of extension. US identified an interruption (curved arrow) of the hyperechoic cortical profile of the coronoid process (C), just cranial to the insertion of the brachialis (br). There was associated mild intra-articular effusion. HC, humeral capitellum. c Left healthy side for comparison, d Additional oblique view of the right elbow confirms the fracture... 

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Major NM, Crawford ST (2002) Elbow effusions in trauma in adults and children is there an occult fracture AJR Am J Roentgenol 178 413-418... 

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