Congenital radial head dislocation (CRHD) is a rare orthopedic condition that frequently goes undiagnosed due to its asymptomatic presentation in early life. It is often identified incidentally during imaging studies for unrelated complaints or trauma. CRHD is often associated with inherited syndromes, emphasizing the genetic predisposition in this condition. While the majority of individuals remain asymptomatic in childhood, many may develop symptoms later in life, including joint stiffness, restricted range of motion, locking of the elbow joint, and aesthetic concerns related to elbow deformity. These delayed presentations can pose diagnostic challenges and contribute to a late diagnosis.
We report the case of a previously asymptomatic patient who presented after a fall with pain in the right elbow. Radiographic imaging revealed radial head dislocation, with characteristic findings including a dysplastic joint, hypoplastic capitulum, convex radial head, and pseudoarthrosis. Further evaluation with X-rays of the contralateral elbow showed similar abnormalities, leading to a diagnosis of bilateral congenital radial head dislocation.
Despite the structural abnormalities observed, the patient was managed conservatively without surgical intervention. Follow-up over a five-year period demonstrated satisfactory functional outcomes, with no significant worsening of symptoms or range of motion. This case highlights the importance of recognizing CRHD, particularly in patients who remain asymptomatic until adulthood or present following trauma. Conservative management can be an effective treatment approach in cases without severe functional impairment or pain, reinforcing the need for individualized treatment plans based on the patient's clinical presentation and functional demands.