Acute elbow trauma in children: role of ultrasonography.
BACKGROUND
The diagnosis of occult elbow fracture in children is often challenging due to equivocal or negative repeated radiographic findings.


OBJECTIVE
To evaluate the potential diagnostic role of US in children who have sustained elbow trauma with an elbow joint effusion but no fracture seen on initial radiographs.


METHODS
The study included 14 consecutive children (age range 5-15 years) with elbow trauma whose elbow radiographs showed an effusion without fracture who underwent emergency imaging (within the first 72 h) with US and MRI. The aim of US was to demonstrate a lipohaemarthrosis in relation to a cortical fracture. MR imaging was used as the reference to differentiate fracture from bone or muscle contusions.


RESULTS
In seven children US demonstrated a lipohaemarthrosis, and MRI demonstrated a cortical fracture in all these children. Conversely, among the seven children with simple haemarthrosis seen on US, MRI did not identify a cortical fracture in six and demonstrated a cortical fracture in one.


CONCLUSIONS
Posttrauma elbow joint effusion in children is not always related to a cortical fracture. US appears to be a reliable, accurate, widely available and effective low-cost tool in these cases. The diagnostic clue is the detection of a lipohaemarthrosis in the articular recess.
Zuazo
Iñaki
I
Service d'Imagerie Anténatale, de la Femme et de l'Enfant, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France.
Bonnefoy
Olivier
O
Tauzin
Catherine
C
Borocco
Antoine
A
Lippa
Alain
A
Legrand
Mathieu
M
Chateil
Jean-François
JF
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004550:Elbow / Q000000981:diagnostic imaging*; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography; D000092464:Elbow Injuries