A bursal component of the anterior elbow fat pad overlying the coronoid and radial fossae, which elevates on lateral X-ray when intra-articular elbow fluid accumulates (the anterior fat pad sign). The fat pad itself contains a bursa-like synovial-lined space that participates in joint fluid dynamics.
The anterior elbow fat pad sign on lateral X-ray — an elevated sail-shaped lucency anterior to the distal humerus — is a reliable indicator of intra-articular elbow pathology including occult radial head fractures, intra-articular loose bodies, and elbow haemarthrosis. The posterior fat pad sign is even more specific for significant elbow effusion. These fat pad signs must be sought in any traumatic elbow X-ray, particularly in children where radial head fractures may otherwise be missed.
Anterior elbow fat pad elevation from intra-articular fluid accumulation in occult radial head fracture or elbow haemarthrosis, prompting MRI for fracture characterisation and management planning when standard X-ray shows no fracture.
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