National Board of Chiropractic Examiners (NBCE) Practice Test

On a well positioned lateral elbow view, an elevated posterior fat pad may indicate ___________________.

1. Osteoarthritis

2. Intra articular fracture

3. Epicondylitis

4. Joint effusion

The correct answer is: Intra articular fracture

An elevated posterior fat pad on a well-positioned lateral elbow view is commonly associated with intra-articular fractures. In an intact elbow joint, the fat pads are typically not visualized or are minimally displaced. When there is an intra-articular fracture, such as a fracture of the radial head or other structures within the elbow joint, it can cause the posterior fat pad to become elevated due to increased intra-articular pressure or hematoma formation. This phenomenon occurs because the presence of blood or fluid results in the displacement of the fat pad. Healthcare professionals often utilize the appearance of displaced fat pads on imaging to identify underlying fractures, especially when the fractures may not be directly visible on the X-ray itself. In other scenarios, such as with joint effusion, the situation may also lead to an elevated fat pad, but the definitive link between an elevated posterior fat pad and intra-articular fracture makes this option the most clinically relevant finding in this context.