What is the most likely diagnosis for a 3-year-old child who cries and stops using her arm after being pulled to safety?

• A. Osgood Schlatter disorder
• B. Nursemaid's elbow
• C. Tennis elbow
• D. Radial head fracture

Answer: (B)

The most likely diagnosis for a 3-year-old child who suddenly stops using her arm after being pulled to safety is nursemaid's elbow. This condition, formally known as radial head subluxation, frequently occurs in young children due to their anatomy.

In this case, the mechanism of injury typically involves a sudden pulling or tugging on the child's arm, which can occur when a caregiver pulls a child to safety, such as in a moment of panic. The annular ligament, which holds the radial head in place, can get trapped in the elbow joint, causing pain and a reluctance to use the affected arm. This sudden onset of pain and functional limitation aligns perfectly with the scenario presented.

Nursemaid's elbow is quite common in children between the ages of 1 and 4, making it consistent with the child's age. Given the context of an injury related to being pulled and the resultant change in behavior (refusal to use the arm), this diagnosis fits the clinical picture well.

Conversely, Osgood Schlatter disorder typically affects older children and adolescents involved in sports and activities that place stress on the knee, while tennis elbow (lateral epicondylitis) is an overuse injury common in adults, and a