Question

A 14-year-old patient who fell on an outstretched hand complains of proximal forearm pain. X-ray reveals a positive fat pad sign, and the patient is unable to fully extend the elbow. No definitive bony changes are seen on X-ray. The most likely working diagnosis is _____________

Answer 1

The most likely diagnosis for the described symptoms and X-ray findings is a supracondylar humerus fracture, which is common in children following a fall onto the elbow.

Step-by-step explanation:

The most likely working diagnosis for a 14-year-old patient with proximal forearm pain, inability to fully extend the elbow, a positive fat pad sign, but no definitive bony changes seen on X-ray after a fall on an outstretched hand is a supracondylar humerus fracture. This type of fracture is common in children and often results from a fall onto the tip of the elbow, driving the olecranon of the ulna upward and producing a fracture across the distal humerus. This injury can pose risks such as compression of the artery to the forearm or damage to major nerves that may result in ischemia or irreparable harm to the forearm muscles.