A 7-year-old child sustains an elbow injury. On X-ray, which epiphyseal ossification center is expected to be present in the elbow at this age?

• A Capitulum only
• B Capitulum, radial head, and internal (medial) epicondyle ✓
• C All six centers (CRITOE complete)
• D Capitulum and trochlea only

Explanation

The mnemonic CRITOE gives the order of appearance of elbow ossification centers: Capitulum (1 year), Radial head (3 years), Internal (medial) epicondyle (5 years), Trochlea (7 years), Olecranon (9 years), External (lateral) epicondyle (11 years) — each approximately 2 years apart. At age 7, the expected centers present are C, R, I (capitulum, radial head, medial epicondyle), and the trochlea appears at exactly 7 years. So at age 7, one would expect 4 centers (capitulum, radial head, medial epicondyle, and beginning trochlear ossification). In this question, option B listing the first three is the closest correct answer for a 7-year-old BEFORE the trochlea has fully appeared.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.