$posterior fat pad sign supracondylar fracture$

The Importance of Proper Positioning in Elbow Radiography

When it comes to assessing a supracondylar fracture, accurate positioning is crucial. A recent case highlights the significance of correct technique in capturing diagnostic images. In this instance, the radiographer performed 'mixed' views of the forearm, which unfortunately rendered them inadequate for assessment of the radius.

A posterior fat pad sign is often used as an indicator of a supracondylar fracture. However, without proper positioning, it can be challenging to accurately identify this sign. The anterior humeral line should fall within the anterior third of the capitellum to suggest a supracondylar fracture.

When performing lateral elbow radiography, it's essential to position the patient correctly. This includes ensuring that the patient's humerus is horizontal, their hand is raised slightly (with possible adjustment for children), and their wrist is in a lateral position. Additionally, the elbow should be flexed to 90 degrees if possible.

Proper positioning is not always easy to describe, but it's essential for achieving diagnostic-quality images. In fact, the lateral elbow projection - whether pediatric or adult - is considered one of the most difficult views in radiography.

$posterior fat pad sign supracondylar fracture$

In this case, the patient, a 2-year-old girl, presented with an unwitnessed fall and was referred for right forearm radiography due to a painful right arm. Unfortunately, the initial images were inadequate for assessment, highlighting the importance of correct positioning and technique.

$posterior fat pad sign supracondylar fracture$

By understanding the importance of proper positioning in elbow radiography, radiographers can ensure that they capture diagnostic-quality images, facilitating accurate diagnoses and effective treatment for patients like this young girl.

$posterior fat pad sign supracondylar fracture$

Posterior fat pad sign supracondylar fracture