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The fat pad sign following elbow trauma. Its usefulness and reliability in suspecting “invisible” fractures

1970; Elsevier BV; Volume: 21; Issue: 1 Linguagem: Inglês

10.1016/s0009-9260(70)80151-9

1365-229X

Stanley P. Bohrer,

Bone fractures and treatments

The dorsal fat pad of the elbow joint lies within the olecranon fossa and is not radiographically visible under normal circumstances. An effusion into the elbow joint will displace the fat pad dorsally and it will become visible on a lateral radiograph of the elbow. Visualization of a dorsal fat pad in cases of trauma should alert the radiologist to the probability of a fracture even if one is not apparent. The author found 8 patients in whom a fracture had been missed. The initial radiographs had shown a dorsal fat pad but the small fractures had been overlooked, though they were seen retrospectively. Their presence was confirmed by later films showing periosteal reaction. The author's study suggests that a fat pad may be found in the absence of a fracture, being due to a joint effusion only. However, this is difficult to prove because a tiny intracapsular fracture may escape radiological detection. The dorsal fat pad of the elbow joint lies within the olecranon fossa and is not radiographically visible under normal circumstances. An effusion into the elbow joint will displace the fat pad dorsally and it will become visible on a lateral radiograph of the elbow. Visualization of a dorsal fat pad in cases of trauma should alert the radiologist to the probability of a fracture even if one is not apparent. The author found 8 patients in whom a fracture had been missed. The initial radiographs had shown a dorsal fat pad but the small fractures had been overlooked, though they were seen retrospectively. Their presence was confirmed by later films showing periosteal reaction. The author's study suggests that a fat pad may be found in the absence of a fracture, being due to a joint effusion only. However, this is difficult to prove because a tiny intracapsular fracture may escape radiological detection.