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A bruised dimple on an injured elbow: what does it mean?
  1. Osamu Nomura1,
  2. Atsushi Tanji2,
  3. Nobuaki Inoue1
  1. 1Division of Pediatric Emergency Medicine, Department of Pediatric Emergency and Critical Care Medicine, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
  2. 2Division of Orthopedic Surgery, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
  1. Correspondence to Dr Osamu Nomura, Division of Pediatric Emergency Medicine, Tokyo Metropolitan Children's Medical Center, 2-8-29 Musashidai, Fuchu-shi, Tokyo, Japan; osamunomura{at}hotmail.com

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Clinical introduction

An 8-year-old girl was brought to the emergency room complaining of severe pain and a deformity in her left elbow after falling off a trampoline with her hand outstretched. A cursory examination revealed a dimple and subcutaneous haematoma on the anterior portion of the distal arm but no apparent neurovascular defects (figure 1).

Figure 1

Photograph of the right elbow on arrival showing puckering skin with subcutaneous haematoma.

Question

What is the most likely diagnosis of the injury?

  1. A …

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