Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 5 1 2020 07 20 7 11 Ehsan Hedayat Department of orthopedic Surgery, Dr Shariati Hospital , Tehran University of Medical Sciences, Tehran, Iran. Apostolou Nicolas Department of Orthopedic Surgery, Centre Hospitalier Henri Duffaut, Avignon, France Mohammad Aref Mohammadi Department of orthopedic Surgery, Dr Shariati Hospital , Tehran University of Medical Sciences, Tehran, Iran. Mohammd Hossein Nabian Department of Orthopedic Surgery, Shariati Hospital,School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2020 02 28 2020 03 25 Trauma to the pediatric’s elbow are common and may result in different types of injuries such as bony, cartilaginous or soft tissue injuries. Fall on an outstretched hand is the most common mechanism of injury that mostly may result in hyperextension or valgus load to the elbow [1,2]. Comparing with adults, pediatric elbow fractures have a higher incidence and variability in fracture patterns [3]. 65 to 75% of all pediatric fractures are related to upper extremity. The most common is supracondylar humerus fracture followed by lateral condyle and medial epicondyle fractures [4]. Interpretation of pediatric elbow radiography needs a systematic approach to prevent misdiagnosis. In this study we explained a six-steps approach to an elbow radiography for better diagnosis of the injury. The quality of radiography, identification of the presence and position of ossification centers, a search for effusion and localized soft tissue swelling, check the alignments, check the bone cortices and finally a focused search to avoid common mistakes based on the history and clinical examination of the patient are discussed in details. https://jost.tums.ac.ir/index.php/jost/article/view/163 https://jost.tums.ac.ir/index.php/jost/article/download/163/143