Urgent Bite 228 - Thinking about the Sail Sign

The Podcasts of the Royal New Zealand College of Urgent Care

We always look for the sail sign when reviewing radiographs of the elbow, but how often are they associated with occult fractures?

Check out the papers mentioned

Skaggs DL, Mirzayan R. The posterior fat pad sign in association with occult fracture of the elbow in children. J Bone Joint Surg Am. 1999 Oct;81(10):1429-33. doi: 10.2106/00004623-199910000-00007. PMID: 10535592.

https://pubmed.ncbi.nlm.nih.gov/10535592/

Al-Aubaidi Z, Torfing T. The role of fat pad sign in diagnosing occult elbow fractures in the pediatric patient: a prospective magnetic resonance imaging study. J Pediatr Orthop B. 2012 Nov;21(6):514-9. doi: 10.1097/BPB.0b013e328355e5d8. PMID: 22735922.

https://pubmed.ncbi.nlm.nih.gov/22735922/

Kappelhof B, Roorda BL, Poppelaars MA, The B, Eygendaal D, Mulder PGH, van Bergen CJA. Occult Fractures in Children with a Radiographic Fat Pad Sign of the Elbow: A Meta-Analysis of 10 Published Studies. JBJS Rev. 2022 Oct 24;10(10). doi: 10.2106/JBJS.RVW.22.00114. PMID: 36326720.

https://pubmed.ncbi.nlm.nih.gov/36326720/

Scheier E, Fuchs L, Taragin BH, Balla U, Shavit I. Children With Elbow Injuries and Sonographic Elevated Posterior Fat Pad but No Identifiable Posterior Fat Pad on Lateral Radiographs: A Case Series. J Ultrasound Med. 2023 Jul;42(7):1617-1624. doi: 10.1002/jum.16173. Epub 2023 Jan 12. PMID: 36633969.

https://pubmed.ncbi.nlm.nih.gov/36633969/

Check out the Radiopaedia Article on the Sail Sign

Gaillard F, Feger J, Ismail M, et al. Sail sign (elbow). Reference article, Radiopaedia.org (Accessed on 29 Aug 2024) https://doi.org/10.53347/rID-2014

Check out the original paper by Norell

NORELL HG. Roentgenologic visualization of the extracapsular fat; its importance in the diagnosis of traumatic injuries to the elbow. Acta radiol. 1954 Sep;42(3):205-10. doi: 10.3109/00016925409174478. PMID: 13206822.

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