Which imaging modality is used to evaluate a radial head fracture?

• A. Ultrasound only.
• B. X-ray (AP & lateral views) and possibly CT or MRI.
• C. PET scan.
• D. Doppler ultrasound.

Answer: (B)

Plain X-ray imaging in two views is the first-line approach for suspected radial head fracture. Anteroposterior and lateral elbow radiographs quickly show whether the radial head is fractured, displaced, or involved in elbow alignment, and they guide initial management.

If the fracture isn’t fully defined on X-ray, or a complex intra-articular fracture is suspected, a CT scan provides detailed cross-sectional images that delineate fracture fragments and articular involvement, which is crucial for planning treatment or surgery. MRI is considered when there’s concern for soft-tissue injury around the elbow or for occult fractures not visible on X-ray, such as injuries to ligaments, the TFCC, or cartilage.

Ultrasound has limited utility for bone injuries like radial head fractures and is not the standard imaging modality for this purpose, while PET and Doppler ultrasound don’t assess bony trauma.