Title: Pediatric Elbow X-ray Interpretation<br/>Author: Brian Corwell<br/><a href='http://umem.org/profiles/faculty/294/'>[Click to email author]</a><hr/><p>
Is that a fracture or a growth plate?</p>
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Pediatric elbow x-rays are complicated to interpret due to the large number of ossification centers.</p>
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Elbow trauma is common in pediatrics.</p>
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Ossification centers of the elbow appear in a reliable chronologic pattern which aids in distinguising fractures from growth plates.</p>
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Note the age ranges are an estimate with great variability. For example, girls can develop these up to 2 years earlier than boys.</p>
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The numbers 1/3/5/7/9/11 correspond to the average age of development of each ossification center</p>
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Years of fusion shown below in ()</p>
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Capitellum (12-14yo)</p>
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Radial head (14-16yo)</p>
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Medial epicondyle (16-18yo)</p>
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Trochlea (12-14yo)</p>
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Olecranon (15-17yo)</p>
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Lateral epicondyle (12-14yo)</p>
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Consider ordering films of both elbows to compare if in doubt.</p>
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How is this useful? If the trochlear center is present, but there is no medial epicondyle then you are most likely looking at a fx where the ossification center has been avulsed and displaced. </p>
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