A WOMAN was seen in the emergency room following a fall. She complained of pain in the elbow. Examination demonstrated swelling of the elbow with a decreased range of motion. Roentgenograms were obtained (Fig 1 and 2).
Fracture of the elbow with positive fat pad sign.
The lateral roentgenogram of the elbow (Fig 1) shows two soft-tissue curvilinear radiolucencies, one projecting anterior to and the other posterior to the distal area of the humerus just above the elbow joint. Neither the anteroposterior nor the lateral view shows a fracture.The lucent shadows represent the fat pads overlying the distal area of the humerus, displaced by fluid in the elbow joint. Fat pads are often seen on the lateral roentgenogram of the flexed elbow in a patient who has had recent trauma, and are generally associated with a fracture. In most cases, the fracture is apparent radiographically, and
Hunter RD. Swollen Elbow Following Trauma. JAMA. 1974;230(11):1573-1574. doi:10.1001/jama.1974.03240110063026