We assessed the RHC view in acute elbow trauma and attempted to evaluate the significance of displaced fat pads in such cases. Subjects and MethodsSubjects were 130 consecutive patients presenting with acute elbow trauma. A total of 135 examinations were performed in these patients. The following views were obtained immediately:AP, true lateral (elbow flexed to 90#{176} with the hand and wrist at 90#{176} to the radiographic table), conventional radial-head (two views with the elbow flexed to 900: the first with the palm of the hand in contact with the table and the second with the hand rotated internally), and RHC.All radiographs routinely were reported by two of us (M. A. H-C., P. J. S.) together at the time of presentation.Patients with abnormal fat pads but without bony injury were requested to return for repeat examination 2 weeks later. A visible dorsal fat pad and/or displacement of the anterior fat pad was considered to be abnormal. At the end of the study, all radiographs of any patient in whom an abnormality had been detected were reviewed. All radiographs from all cases were sorted randomly and viewed individually by a radiology senior registrar (P. J. S.) and a consultant (M. C.). Each view was scored for the presence or absence of a fracture. At the same time, displacement of fat pads was assessed on the true lateral view. Finally, the radiographs were re-sorted into complete sets for each patient, then reviewed by the two observers together. A consensus decision was made on radiographs in which there had been previous disagreement.In those patients with fractures, the view most clearly demonstrating the fracture and the bony displacement was selected from each set. ResultsDownloaded from www.ajronline.org by 34.215.51.103 on 05/11/18 from IP address 34.215.51.103.

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