Abstract
Elbow complaints are frequently encountered in the emergency setting. Mechanism of injury often involves direct trauma or a fall on the outstretched hand and arm. Abnormal findings on elbow radiographs can be challenging to identify, thus a systematic approach is essential to identify subtle findings especially with occult fractures. Maintaining a high index of suspicion, identification of normal and abnormal fat pad signs, and proper alignment of specific anatomical lines on elbow radiographs can assist in the identification of hidden fractures.