Question:easy
A 4-year-old child, while playing, was suddenly swung around by the elbow from the maid's hand and is now crying continuously, not allowing anyone to touch the elbow. The child keeps the elbow extended. What is the most likely diagnosis?
A 4-year-old child, while playing, was suddenly swung around by the elbow from the maid's hand and is now crying continuously, not allowing anyone to touch the elbow. The child keeps the elbow extended. What is the most likely diagnosis?
Show Hint
A sudden pull on a toddler's extended arm with no swelling suggests what?
Updated On: Jun 23, 2026
- Radial head fracture
- Pulled elbow
- Supracondylar fracture
- Elbow dislocation
Show Solution
The Correct Option is B
Solution and Explanation
Mechanism first: Young child plus a sudden longitudinal pull or swing on the arm equals nursemaid's elbow (pulled elbow), a radial head subluxation under the annular ligament. The history alone almost makes the diagnosis.
Classic picture: The toddler keeps the arm quiet by the side, refuses to use it, and cries if anyone touches it, but crucially there is no swelling, bruising or bony deformity. That gentle presentation separates it from a fracture.
Sorting the distractors: A supracondylar fracture and an elbow dislocation come from a fall on an outstretched hand and bring obvious swelling or deformity. A radial head fracture is rare in a 4-year-old and again needs a fall, not a tug. So with this pull mechanism and no deformity, the diagnosis is pulled elbow.
Classic picture: The toddler keeps the arm quiet by the side, refuses to use it, and cries if anyone touches it, but crucially there is no swelling, bruising or bony deformity. That gentle presentation separates it from a fracture.
Sorting the distractors: A supracondylar fracture and an elbow dislocation come from a fall on an outstretched hand and bring obvious swelling or deformity. A radial head fracture is rare in a 4-year-old and again needs a fall, not a tug. So with this pull mechanism and no deformity, the diagnosis is pulled elbow.
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