A pre-hospital team is assessing a 4-year-old child who has fallen from a swing and landed on her outstretched hand. She has pain and swelling around ...

Question

A pre-hospital team is assessing a 4-year-old child who has fallen from a swing and landed on her outstretched hand. She has pain and swelling around the elbow with a posterior fat pad sign visible on the X-ray at hospital. The X-ray shows no visible fracture. What does the posterior fat pad sign indicate?

Accepted Answer

An occult fracture is present - the posterior fat pad is displaced by a joint effusion (haemarthrosis) from a fracture that is not visible on plain X-ray; the most common occult elbow fracture in children is a supracondylar fracture

Answer

A ligament injury without fracture

Answer

A dislocated elbow that has spontaneously reduced

Answer

An infection causing a joint effusion

Answer

The elbow is normal - fat pad signs are a normal variant in children

uk-dipimc MCQ (SBA): Posterior Fat Pad Sign - Occult Fracture