Step 2

Orthopedics 2

A 4-year-old girl is brought to the emergency department for severe pain in her right arm for the past 2 hours. She was holding hands with her 7-year-old sister while they were running across the park, and the patient tripped and hit the ground. She has no previous history of hospitalizations or surgeries. Development has been normal for her age, and her immunizations are up to date. Her vital signs are within normal limits. On physical examination, the patient is holding her right arm close to her chest with her elbow slightly flexed and the forearm pronated. There is no tenderness, swelling, or erythema over the right elbow joint. Radial pulse is present. Attempts at passively supinating her forearm elicit pain and cause her distress.

Which of the following is the most appropriate next step in the management of this patient?

  • A) Apply ice packs on the right forearm and elevate arm while resting
  • B) Cast on the right elbow
  • C) Hyperpronation of the right arm
  • D) Splint on the right elbow
  • E) X-ray of the right elbow and forearm


Danielle Uayan


Dr. Ted O'Connell