Radial Head Fracture/Posterior Fat Pad/Spinnaker Sail Sign Copy

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.



 Illustration 59 Radial Head Fracture


If an elbow fracture is present—

1…..You might see a prominent anterior fat pad ( in the shape of a spinnaker sail )

2…..You might see a visible posterior fat pad.

The converse is also a true statement– If you observe the following

1…..Spinnaker sail sign is present.

2…..Posterior fat pad sign is present.

You should at least label the X-Ray as ” probable occult fracture “……. if it fits the clinical picture..

Please click on


to see another example of the posterior fat pad sign and a list of clues suggesting the elbow fracture.