Sail sign (elbow)

Changed by Daniel J Bell, 21 Apr 2021

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The sail sign on an elbow radiograph, also known as the anterior fat pad sign, describes the elevation of the anterior fat pad to create a silhouette similar to a billowing spinnaker sail from a boat. It indicates the presence of an elbow joint effusion.

The anterior fat pad is usually concealed within the coronoid fossa or seen paralleling the anterior humeral line.  When there is a joint effusion, the anterior fat pad (which is intra-articular, but extrasynovial) becomes elevated.

Elevation of the anterior fat pad usually heralds the presence of an intra-articular fracture. In adults, this is usually a radial head fracture whereas in children, the commonest cause of a raised elbow fat pad is a supracondylar fracture

Where a fat pad is raised and no fracture is demonstrated, an occult fracture should be suspected.

Video tutorial

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See also

  • +<li>
  • +<a href="/articles/sail-sign-larynx">laryngeal sail sign</a>: unilateral dilated laryngeal ventricle in vocal cord paralysis</li>
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FigFigure 1: sail boat (photo)

Image 2 Diagram ( update )

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Figure 12: elbow effusion (diagram)
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Image 4 X-ray (Lateral) ( update )

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Image 5 CT (non-contrast) ( update )

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Image 6 Annotated image (Lateral) ( update )

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Image 9 X-ray (Lateral) ( update )

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Image 10 X-ray (Lateral) ( update )

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