Urgent Care Evaluation and Management of Pediatric Elbow and Forearm Pain, Part II (Trauma CME)

Enlarge Image
Delivery Method:	Online
$99.00 ADD TO CART OR SUBSCRIBE AND SAVE Back To Store

Publication Date: April 2025 (Volume 4, Number 4)

CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I credits, 4 AAFP Prescribed credits, and 4 AOA Category 2-B CME credits. CME expires 04/01/2028.

Specialty CME Credits: Included as part of the 4 credits, this CME activity is eligible for 3 Trauma credits, subject to your state and institutional approval.

Author

Peer Reviewers

Abstract

Elbow and forearm pain in children is a common presentation in urgent care. The possible causes of the pain include trauma, overuse, or underlying conditions. While many of these causes are minor and self limiting, some can lead to serious complications if missed. The unique anatomy of growing children, along with challenges in obtaining a reliable history and performing an examination, can make diagnosis difficult. This article reviews both traumatic and nontraumatic causes of elbow and forearm pain in children, including fractures, dislocations, overuse injuries, and inflammatory conditions. It outlines a systematic approach to evaluation, highlights high-risk injuries, and provides practical management strategies.

Case Presentations

A 2-year-old girl presents to urgent care refusing to move her right arm…

• The mother says she was playing with the child in the park and swung her around by the wrists, which she seemed to enjoy.
• The mother then heard a pop, after which the child stopped using the right arm. The mother denies any swelling or bruising of the wrist or elbow.
• The child appears comfortable, and the right arm is held close to the body in a slightly flexed and pronated position.
• The mother tearfully asks you if she broke her child’s arm...

A 7-year-old boy is brought into urgent care, screaming in pain and protecting his left forearm with his right hand…

• He fell from the monkey bars on the playground 30 minutes ago.
• A distal forearm deformity is visible from a distance, and no open wound is appreciated.
• You consider whether this patient needs radiographic images and an orthopedic consultation...

A 13-year-old baseball player presents to urgent care complaining of right elbow pain…

• He states that his pain has become progressively worse over the last 4 weeks. He ices at home and takes acetaminophen, but it has not gotten any better. He denies recent trauma or swelling to his elbow joint.
• The patient is an avid pitcher and plays baseball 5 to 6 times a week and has had 2 to 3 games every weekend for the last month.
• His father asks if he can just get a brace and some pain medication so he can play in the state tournament this weekend.
• You are pretty sure this is an overuse injury, but you wonder if there is more going on...

Accreditation:

EB Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.