The patient is an otherwise healthy child, 3.5 years of age, who presents with acute pain in his right lower arm to the elbow. Examination reveals multiple fractures.

View the image taken (Figure 1) and consider what your diagnosis and next steps would be.
Resolution of the case is described on the next page.

Clinical Challenge: May, 2011

Nahum Kovalski, BSc, MDCM

Clinical Researcher at TEREM Emergency Services
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