Searching for the Elbow Fracture. . If the plain film of the elbow fails to demonstrate a fracture and yet you are clinically suspicious of a fracture, e.g. findings of severe edema and pain and limited range of motion, you should continue your search as follows : We know that if a fracture occurs in the elbow ( especially when it communicates with the joint ), edema, bleeding and lifting of the fat pad surrounding the periosteum often occurs. PEARL The posterior fat pad will reveal itself as a faint gray shadow crescent-shaped hue ( will often require utilization of the zooming and hot-lighting of the area ). Please be aware that the lateral X-Ray of the NORMAL elbow might demonstrate an anterior fat pad ( See Illustration 58 ) but notice the absence of a visible posterior fat pad. 
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