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This case came across the wires on Instagram – Follow @radiologynemoursch who recently posted this most interesting case!

Diagnosis: Displaced supracondylar fracture

Case description: Child with remote history of a displaced supracondylar fracture presenting with elbow pain. Initial radiographs show a displaced supracondylar fracture. Follow up elbow xray and CT several years later show a small, dysplastic trochlea with V-shaped deformity of the distal humerus. There is also osteochondritis dissecans of the capitellum with subchondral cystic changes around the radiocapitellar joint. Fishtail deformity is a rare, delayed complication of distal humeral fractures resulting from non-developed or underdeveloped trochlea secondary to avascular necrosis. While the primary abnormality is of the ulnotrochlear joint, abnormalities of the radiocapitellar joint are commonly associated including osteochondritis dessicans. Long term outcomes include limited motion, osteoarthritis, loose intra-articulate bodies, cubitus valgus, and chronic radial head subluxation. #nemoursrad

Source: @radiologynemoursch (Instagram)