Elbow X-ray (peds)

Elbow Ossification by Age (CRITOE)

Ossification Center Age of Appearance (add 1yr for boys)
Capitellum 1yr
Radial head 3yr
Internal epicondyle 5yr
Trochlea 7yr
Olecranon 9yr
External epicondyle 11yr

CRITOE.jpg

Reading Film

  • Anterior humeral line should intersect with middle third of capitellum
    • If not, consider supracondylar fracture or lateral condyle fracture
  • Line drawn along axis of radial head and neck should pass through middle of capitellum
    • If not, consider fracture of lateral condyle, radial neck, Monteggia, or elbow dislocation
  • Fat Pads
    • Anterior may be normal or if large may be abnormal ("sail sign")
    • Posterior is always abnormal

See Also