Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Pediatric Elbow - Examination and X-rays

25,207 views

Published on

Get a quick overview of children's elbow injuries and how to examine the child with a painful elbow injury. Find out more about hand and arm problems at http://www.noelhenley.com.

Ozark Orthopaedic: Henley C Noel MD
3317 North Wimberly Drive, Fayetteville, AR 72703
(479) 521-2752

  • Be the first to comment

Pediatric Elbow - Examination and X-rays

  1. 1. The Child’s Elbow C. Noel Henley, MD http://www.noelhenley.com
  2. 2. Acute Injury http://www.noelhenley.com
  3. 3. Acute Injury• Primary goals of initial evaluation of acute injury http://www.noelhenley.com
  4. 4. Acute Injury• Primary goals of initial evaluation of acute injury - assess neurovascular status http://www.noelhenley.com
  5. 5. Acute Injury• Primary goals of initial evaluation of acute injury - assess neurovascular status - determine urgency of reduction http://www.noelhenley.com
  6. 6. Radiographic Anatomy http://www.noelhenley.com
  7. 7. Radiographic Anatomy• Centers of secondary ossification http://www.noelhenley.com
  8. 8. Radiographic Anatomy• Centers of secondary ossification - predictable order http://www.noelhenley.com
  9. 9. http://www.noelhenley.com
  10. 10. Radiographic Anatomy http://www.noelhenley.com
  11. 11. Radiographic Anatomy• Multiple ossification centers may be mistaken for a fracture http://www.noelhenley.com
  12. 12. Radiographic Anatomy• Multiple ossification centers may be mistaken for a fracture• Radiographs of the opposite elbow may help http://www.noelhenley.com
  13. 13. Radiographic Anatomy http://www.noelhenley.com
  14. 14. Radiographic Anatomy• Relationships to look for http://www.noelhenley.com
  15. 15. Radiographic Anatomy• Relationships to look for - capitellum should always line up with radial head - if not... http://www.noelhenley.com
  16. 16. Radiographic Anatomy• Relationships to look for - capitellum should always line up with radial head - if not... • lateral condyle fracture http://www.noelhenley.com
  17. 17. Radiographic Anatomy• Relationships to look for - capitellum should always line up with radial head - if not... • lateral condyle fracture • Monteggia fracture http://www.noelhenley.com
  18. 18. Radiographic Anatomy• Relationships to look for - capitellum should always line up with radial head - if not... • lateral condyle fracture • Monteggia fracture • elbow dislocation http://www.noelhenley.com
  19. 19. http://www.noelhenley.com
  20. 20. Radiographic Anatomy http://www.noelhenley.com
  21. 21. Radiographic Anatomy• Relationships to look for http://www.noelhenley.com
  22. 22. Radiographic Anatomy• Relationships to look for - anterior humeral line http://www.noelhenley.com
  23. 23. Radiographic Anatomy• Relationships to look for - anterior humeral line • should bisect the capitellum on a lateral radiograph - if not... http://www.noelhenley.com
  24. 24. Radiographic Anatomy• Relationships to look for - anterior humeral line • should bisect the capitellum on a lateral radiograph - if not... - suspect a supracondylar humerus fracture http://www.noelhenley.com
  25. 25. http://www.noelhenley.com
  26. 26. http://www.noelhenley.com
  27. 27. Examination http://www.noelhenley.com
  28. 28. Examination• Tips on examining the painful child http://www.noelhenley.com
  29. 29. Examination• Tips on examining the painful child - observation http://www.noelhenley.com
  30. 30. Examination• Tips on examining the painful child - observation • arm/elbow held close? http://www.noelhenley.com
  31. 31. Examination• Tips on examining the painful child - observation • arm/elbow held close? • elbow flexed/extended/pronated? http://www.noelhenley.com
  32. 32. Examination• Tips on examining the painful child - observation • arm/elbow held close? • elbow flexed/extended/pronated? • bruising, dimpling of skin (esp. anterior elbow)? http://www.noelhenley.com
  33. 33. Examination http://www.noelhenley.com
  34. 34. Examination• Tips on examining the painful child http://www.noelhenley.com
  35. 35. Examination• Tips on examining the painful child - palpation (joint above, joint below, too) http://www.noelhenley.com
  36. 36. Examination• Tips on examining the painful child - palpation (joint above, joint below, too) • start with other side http://www.noelhenley.com
  37. 37. Examination• Tips on examining the painful child - palpation (joint above, joint below, too) • start with other side • lateral, medial “bones” + olecranon process + radial head/neck http://www.noelhenley.com
  38. 38. Examination• Tips on examining the painful child - palpation (joint above, joint below, too) • start with other side • lateral, medial “bones” + olecranon process + radial head/neck • pain worse with pro/sup than with flex/ extension? http://www.noelhenley.com
  39. 39. Thanks! Find out more athttp://www.noelhenley.com www.noelhenley.com

×