Knowledge of the order and ages of appearance of the ossification centers of the elbow is essential in differentiating fractures from normal ossification centers in the pediatric elbow. A simple mnemonic, CRITOE, can be used to remember the sequence of appearance.
Ossification centers - Approximate age of appearance
Capitellum - 1 year
Radial head - 5 years
Internal epicondyle (Medial epicondyle) - 7 years
Trochlea - 10 years
Olecranon - 10 years
External epicondyle (Lateral epicondyle) - 11 years
Note: Females tend to have an earlier appearance of ossification centers by 1-2 years.
Diagram - The ossification centers of the elbow
Radiograph demonstrating ossification centers
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