Assessment of the radial head-capitellum view and the dorsal fat-pad sign in acute elbow trauma.

The radial head-capitellum (RHC) view was assessed in a prospective study of 130 patients with acute elbow trauma in whom 35 fractures were identified. The RHC view demonstrated only 16 of the 32 fractures available for review, including one fracture that was not seen on routine projections. Fat pads were displaced in all 31 patients with fractures; fat-pad displacement was demonstrated on the true lateral view in 29 and on the conventional radial-head view in two patients. Routine use of the RHC projection is not justified in all cases of elbow trauma. It may be added in cases in which no fracture has been identified but clinical suspicion remains high or displaced fat pads are seen on the routine projections.