Radial Head Elbow Fracture with displaced Fat Pads
Intra-Articular Fracture of the Elbow with displaced fat pads (hemarthrosis). Why are the fat pads important?⁣⁣
⁣⁣These are intra-capsular but extra synovial structures which appear on a radiograph as dark streaks in the grey soft tissue surrounding the elbow joint.⁣⁣
The anterior fat pad may be seen in most normal elbows closely apposed to the humerus while the posterior fat pad is normally not visible in a radiograph as it is located deep within the olecranon fossa.⁣⁣
⁣⁣If the fat pads are displaced it indicates joint effusion/hemorrhage which is evidence of a serious intra-articular injury. So even in a case where the fracture is not immediately evident, raised fat pads should make you very suspicious about the possibility of a fracture.⁣⁣
⁣⁣Between the two fat pads, the posterior fat pad is more specific and is always abnormal. It denotes a considerable amount of blood in the joint while the anterior fat pad is the luckier one which has a name called the “Sail sign”.⁣⁣
⁣⁣In adults, the most common fracture which leads to this appearance is that of the radial head while in children it is the supra condylar fracture.⁣⁣

Dr. Devpriyo Pal @drdevrad

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