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Case Notes

History

Elbow pain after fall.

Exam

Frontal and lateral radiographs of the elbow

Prior Study

Dicom

Findings

You scored: 0 / 16

Image Quality	Correct Answer	Your Answer
The lateral radiograph is obliquely imaged.	Yes	NA

Soft Tissues	Correct Answer	Your Answer
A joint effusion is present.	Yes	NA
There is soft tissue edema/fullness overlying the olecranon process, overlying the lateral or medial epicondyles, or elsewhere about the elbow.	Yes	NA
There is soft tissue laceration or radiopaque foreign body.	No	NA

Alignment	Correct Answer	Your Answer
The anterior humeral line courses anterior or posterior to the middle third of the capitellar ossification center.	No	NA
A line drawn down the center of the radius does not pass through the center of the capitellum on all imaging planes.	Yes	NA
Ulnohumeral alignment is abnormal.	No	NA

Osseous	Correct Answer	Your Answer
The sequence of apophyseal ossification about the elbow is abnormal.	No	NA
The secondary ossification centers are abnormal in size, shape, or position.	No	NA
The physes are widened or irregular.	No	NA
The proximal radius is fractured.	No	NA
The coronoid process is fractured.	No	NA
The olecranon process is fractured.	Yes	NA
The medial or lateral humeral condyles are fractured.	No	NA
Based on the mechanism of visualized injuries, there are additional subtle abnormalities.	No	NA
A marrow replacing osseous lesion is present.	No	NA

Impression

Expert Answer

Type III Monteggia fracture/subluxation.

Your Answer

Recommendations & Acuity

Recommendations

Expert Answer

N/A

Your Answer

Acuity

Expert Answer

Urgent (Action Necessary in a few hours)

Your Answer