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Summary
In the medical literature, the discussion of radial head subluxation (RHS) and nursemaid’s elbow may highlight the ability to diagnose and treat the injured patient without obtaining imaging studies. This case reiterates the importance of a thorough physical examination and the use of appropriate imaging when point tenderness is exposed in the injured limb. With point tenderness to the arm, a child with a presumed RHS, otherwise known as nursemaid’s elbow, should be evaluated using radiographic imaging to prevent additional potentially destructive physical manipulation of the patient’s upper extremity.
- trauma
- orthopaedics
- child abuse
- radiology
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Footnotes
Contributors The patient was seen by MT. MT is a partner at Coordinated Health Scranton Orthopedics and specialises in the treatment of shoulder and elbow arthritis, rheumatoid conditions and sports and traumatic injuries. This includes joint replacement surgery, arthroscopic rotator cuff repair, elbow ligament reconstruction and operative fixation of fractures of the clavicle, shoulder and elbow. He completed his orthopedic residency at Wake Forest University and a fellowship in shoulder and elbow surgery at the Rothman Institute at Thomas Jefferson University. MT edited the paper and served as an adviser in its development. BC is a fourth year medical student at Geisinger Commonwealth School of Medicine in Scranton, PA. Brandon completed undergraduate education at Colgate University in May 2015. BC wrote the paper, processed it for editing, and submitted it to BMJ cases.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent Parental/guardian consent obtained.
Provenance and peer review Not commissioned; externally peer reviewed.