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Elbow Injury

Elbow Injury

A 4-year-old male is brought by his mother to the emergency department for 2 days of left elbow pain following a fall. The elbow initially did not appear badly injured so the boy’s parents elected to wait until the following day before obtaining care. Today the arm looked somewhat swollen and the child was still complaining of pain and was not using the arm.

Vital signs were normal. Physical examination was normal except for guarding and tenderness of the left elbow as well as decreased ability to fully supinate or extend the elbow. No deformity is observed beyond mild swelling. X-ray image is shown below.

What does the x-ray image show?

What should you do next?

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