Elbow Pain in an Adult: Keeping Nursemaid’s Elbow in the Differential Diagnosis

Nursemaid's elbow is a common and well-recognized diagnosis in pediatric patients presenting to the ED.These encounters are often characterized by a classic mechanism of injury, predictable physical examination findings, and a rapid, effective reduction technique, frequently resulting in immediate symptom resolution.As a result, both patients and caregivers typically experience a high degree of satisfaction with the ED visit, particularly when recovery is swift and more serious pathology is excluded.In contrast, nursemaid's elbow is rarely considered in adult patients.The injury is uncommon beyond early childhood and is exceedingly rare after skeletal maturity, largely due to increased annular ligament strength and greater stability of the proximal radioulnar joint.Consequently, clinicians may be less inclined to include radial head subluxation or dislocation in the differential diagnosis when evaluating adults with elbow pain and restricted range of motion.This case of a radial head dislocation in a 21-year-old male underscores the importance of maintaining diagnostic vigilance when clinical findings do not align with more common adult elbow injuries.It highlights the value of thorough history-taking, careful physical examination, and independent review of imaging studies, even when real-time radiologic interpretations are available.Additionally, this case illustrates the risk of premature diagnostic closure when atypical presentations are encountered and reinforces the need to consider less common etiologies, particularly in patients with prior elbow injury or recurrent symptoms.