A 4 year boy complaining of pain around elbow which is held in pronation with extension and normal X ray. What is the probable diagnosis?

ANSWER: (A) Pulled elbowREF: Apley s 8th ed p. 603Nursemaid's elbow, Babysitter's elbow or Pulled elbow is a dislocation of the elbow joint caused by a sudden pull on the extended pronated arm, such as by an adult tugging on an uncooperative child, or swinging the child by the arms during play The technical term for the injury is radial head subluxation.Common in children below 5 years of ageThe child stops using the arm, vdiich is held flexed and pronated.Minimal swelling.All movements are permitted except supination.* The child cries inconsolably Treatment:The affected arm must be held by the attending physician with one hand/finger on the radial head and the other grasping the hand. While applying compression between these two hands, the forearm of the patient is gently supinated and the arm flexed. The physician will usually feel a "click'' if the maneuver is done properly, the child will feel momentary pain, and usually within 5 minutes, the forearm will thereafter function well and painlessly.