Orta Alexander R, Qian Guo, Outlaw Andrew S
Emergency Medicine, Alabama College of Osteopathic Medicine, Dothan, USA.
Internal Medicine, Alabama College of Osteopathic Medicine, Dothan, USA.
Cureus. 2024 Oct 18;16(10):e71801. doi: 10.7759/cureus.71801. eCollection 2024 Oct.
Radial head subluxation (RHS), commonly known as 'nursemaid's elbow,' typically presents in pediatric patients with acute-onset unilateral arm pain and pseudoparalysis. The classic mechanism of injury involves a longitudinal traction force pulling the radial head through the annular ligament. Bilateral RHS is exceedingly rare, with only a few cases documented in the literature; notably, all cases with a provided history and physical exam presented with the classic mechanism of injury, aiding in diagnosis and treatment. Here, we report the case of a two-year-old male with bilateral RHS who presented to the emergency department with bilateral upper extremity pain and weakness following an unwitnessed injury. This case required a broad differential diagnosis, including musculoskeletal injury, central cord syndrome, and spinal cord injury without radiographic abnormality (SCIWORA). It underscores the importance of considering RHS in differential diagnoses, even in atypical presentations, to ensure prompt and effective management.
桡骨头半脱位（RHS），通常被称为“保姆肘”，典型表现为儿科患者急性发作的单侧手臂疼痛和假性麻痹。经典的损伤机制是纵向牵引力将桡骨头拉过环状韧带。双侧RHS极为罕见，文献中仅有少数病例记载；值得注意的是，所有有病史和体格检查记录的病例均呈现出经典的损伤机制，有助于诊断和治疗。在此，我们报告一例两岁男性双侧RHS病例，该患儿在未目睹的受伤后出现双侧上肢疼痛和无力，到急诊科就诊。该病例需要进行广泛的鉴别诊断，包括肌肉骨骼损伤、中央脊髓综合征和无放射学异常的脊髓损伤（SCIWORA）。它强调了即使在非典型表现中，在鉴别诊断时考虑RHS的重要性，以确保及时有效的治疗。
