PMID- 27603193
OWN - NLM
STAT- MEDLINE
DCOM- 20170524
LR  - 20181202
IS  - 1539-2570 (Electronic)
IS  - 0271-6798 (Linking)
VI  - 37
IP  - 3
DP  - 2017 Apr/May
TI  - Significance of the Lateral Humeral Line for Evaluating Radiocapitellar Alignment
      in Children.
PG  - e150-e155
LID - 10.1097/BPO.0000000000000853 [doi]
AB  - BACKGROUND: The radiocapitellar line (RCL) was originally described for
      evaluation of the alignment of the RC joint on lateral images of the elbow.
      Although, many authors have translated the utilization of RCL into coronal
      imaging, previous studies have not been performed to confirm validity. The
      purpose of this paper was to identify an accurate way of evaluating pediatric RC 
      alignment in the coronal plane. METHODS: Thirty-seven anteroposterior (AP)
      radiographs of 37 children were evaluated to determine the position of the RC
      joint in the coronal plane. All had acceptable magnetic resonance imaging (MRI)
      studies available for comparison. The lateral humeral line (LHL), consisting of a
      line along the lateral edge of the ossified condyle of the distal humerus
      parallel to the axis of the distal humeral shaft, was studied as it related to
      the lateral cortex of the radial neck. Three children with a confirmed diagnosis 
      of a Bado III, lateral displaced radius, Monteggia fracture were also evaluated. 
      RESULTS: The LHL passed along the edge of or lateral to the radial neck on all AP
      radiographs and all MRI studies. The RCL failed to intersect the capitellum on 2 
      AP radiographs. On MRI, the RCL also passed lateral to the capitellar
      ossification center in 3 patients. In addition, the RCL was seen passing through 
      the capitellum at a mean of the lateral 30% (range, 0% to 64%) on AP radiographs 
      and 26% (range, 0% to 48%) on MRI. For all 3 children with a Bado III Monteggia
      fracture, the LHL crossed the radial neck and the RCL did not intersect the
      capitellum. CONCLUSIONS: The RCL can fail to intersect the capitellar
      ossification center on AP radiographs and MRI in pediatric elbows without injury.
      The LHL consistently lies lateral to the radial neck in normal elbows and medial 
      to the lateral aspect of the radial neck on all Bado III fracture-dislocations.
      It, therefore, can be used as an adjunct in evaluating the RC joint on AP
      imaging. The RCL most commonly intersects the lateral one third of the
      ossification center on both plain radiographs and MRIs. LEVEL OF EVIDENCE: Level 
      III-diagnostic.
FAU - Souder, Christopher D
AU  - Souder CD
AD  - *Baylor Scott & White Health, Temple, TX daggerRady Children's Hospital San Diego
      double daggerUniversity of California, San Diego, CA.
FAU - Roocroft, Joanna H
AU  - Roocroft JH
FAU - Edmonds, Eric W
AU  - Edmonds EW
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Pediatr Orthop
JT  - Journal of pediatric orthopedics
JID - 8109053
SB  - IM
MH  - Age Factors
MH  - Child
MH  - Child, Preschool
MH  - Diaphyses/anatomy & histology/diagnostic imaging
MH  - Elbow Joint/*anatomy & histology/diagnostic imaging/injuries
MH  - Epiphyses/anatomy & histology/diagnostic imaging
MH  - Female
MH  - Humans
MH  - Humerus/*anatomy & histology/diagnostic imaging
MH  - Infant
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Monteggia's Fracture/diagnostic imaging
MH  - Radiography
MH  - Radius/*anatomy & histology/diagnostic imaging
MH  - Retrospective Studies
EDAT- 2016/09/08 06:00
MHDA- 2017/05/26 06:00
CRDT- 2016/09/08 06:00
PHST- 2016/09/08 06:00 [pubmed]
PHST- 2017/05/26 06:00 [medline]
PHST- 2016/09/08 06:00 [entrez]
AID - 10.1097/BPO.0000000000000853 [doi]
PST - ppublish
SO  - J Pediatr Orthop. 2017 Apr/May;37(3):e150-e155. doi:
      10.1097/BPO.0000000000000853.