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The answer is not always in black and white: a frequently missed diagnosis in a child presenting with elbow pain
  1. Emer McLoughlin1,
  2. Ben Stanhope2,
  3. Karl Johnson1
  1. 1 Radiology Department, Birmingham Children's Hospital, Birmingham, West Midlands, UK
  2. 2 Emergency Department, Birmingham Children's Hospital, Birmingham, West Midlands, UK
  1. Correspondence to Dr Emer McLoughlin, Radiology Department, Birmingham Children's Hospital, Birmingham, West Midlands, B4 6NH, UK.

https://doi.org/10.1136/emermed-2016-205990

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    Clinical introduction

    A 1-month-old baby was referred to a tertiary paediatric centre from a local hospital with a 2-day history of reduced movement and swelling of the left elbow. There was no history of preceding trauma or relevant obstetric history.

    On examination, tenderness and swelling of the left elbow with restriction of movement was noted. There was no evidence of systemic illness or infection.

    Left elbow radiographs were performed (figure 1):

    Figure 1

    AP and lateral radiographs of the left elbow.

    Question

    What is the diagnosis?

    1. Elbow dislocation

    2. Distal humeral supracondylar fracture

    3. Septic arthritis

    4. Distal humeral transphyseal fracture

    Answer: D

    Transphyseal …

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    Footnotes

    • Contributors EM wrote this paper. BS edited it. KJ provided images.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.