BACKGROUND: A nursemaid's elbow most frequently occurs with transient 
longitudinal traction of the pronated forearm and extended elbow, which can be 
reduced by manipulation without sedation. There are circumstances in which the 
history is atypical and reduction of the elbow is unsuccessful. Imaging may be 
helpful in these cases.
METHODS: A 33-month-old child was injured in a fall from a tire swing and 
sustained what was thought to be a nursemaid's elbow. Typical reduction 
maneuvers were unsuccessful. The patient underwent magnetic resonance imaging 
(MRI) with conscious sedation, which demonstrated the entrapment of the annular 
ligament in the radicapitellar joint. A presumed successful reduction was 
performed with confirmed reduction of the annular ligament by immediate MRI.
CONCLUSIONS: To our knowledge, this is the first case report on MRI being used 
to diagnose and confirm treatment of an atypical nursemaid's elbow.
LEVEL OF EVIDENCE: IV.