J Trauma
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Case Reports
The off-profile proximal radial epiphysis: another potential pitfall in the X-ray diagnosis of elbow trauma.
If the elbow is filmed in flexion in a pubertal age child, the proximal radial epiphyseal line may be projected through the articular surface of the radial head on standard or oblique AP views. This can theoretically mimic a fissure or chisel-type fracture. Fractures involving the articular surface of the radial head, however, are extremely rare in children and the true fissure fractures that occur in the adult are notably different in specific radiographic features.
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Thirteen cases of jejunal perforation from blunt trauma are presented. There are no reliable signs or symptoms, and a normal physical examination may be seen. Free intraperitoneal air on plain radiograms is characteristically absent. ⋯ Mortality is usually associated with other serious concomitant injuries, and complications are associated with diagnostic delays. Diagnostic peritoneal lavage is a safe and reliable procedure for establishing an early diagnosis of serious intraperitoneal injury. Its routine use in all cases of serious blunt abdominal trauma is advocated.