Magnetic resonance imaging in pediatric elbow fractures.
OBJECTIVE
Magnetic resonance imaging (MRI) evaluation of pediatric elbow trauma with or without a visible fracture on radiography.


METHODS
MRI was performed in the acute phase in 25 children with an elbow injury. Nine patients with an elbow effusion only on radiographs and 16 with a fracture or luxation seen on radiographs underwent subsequent MRI. No sedation was used.


RESULTS
MRI revealed eight occult fractures (89%) in seven out of nine patients who had only an effusion on radiographs. Based on MRI findings, septic arthritis was suspected in one patient. Two patients out of five with a supracondylar fracture on the radiograph had a cartilage lesion in the humerus. MRI depicted a 3-mm gap on the articular surface in two patients with a lateral condyle fracture, a more accurate fracture location in two patients than the radiographs, and an additional occult fracture in two patients. MRI showed a fracture not seen on radiographs in two of three patients with prior luxation.


CONCLUSIONS
MRI is a sensitive and accurate method in the diagnosis of pediatric elbow injuries, especially when only an effusion is present on radiographs. Occult fractures are more common in pediatric patients with elbow injury than reported earlier.
Pudas
T
T
Department of Radiology, University of Turku, Turku, Finland. tomi.pudas@utu.fi
Hurme
T
T
Mattila
K
K
Svedström
E
E
D000293:Adolescent; D001170:Arthritis, Infectious / Q000175:diagnosis; D002358:Cartilage, Articular / Q000293:injuries; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D004551:Elbow Joint / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000175:diagnosis* / Q000000981:diagnostic imaging; D050724:Fractures, Cartilage / Q000175:diagnosis; D005596:Fractures, Closed / Q000175:diagnosis / Q000000981:diagnostic imaging; D006801:Humans; D006810:Humeral Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging; D004204:Joint Dislocations / Q000175:diagnosis / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D011885:Radius Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D013582:Synovial Fluid; D014458:Ulna Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging; D000092464:Elbow Injuries