Radiographs are often unnecessary and may not be helpful, as the radial head and lateral humeral condyle may not be ossified in a young child. When radiographs are obtained, they may serve as the treatment as well because the radiology technician will supinate and flex the elbow to 90 degrees (the procedure used for reduction of the subluxation) to obtain a proper lateral x-ray of the elbow. Reduce the subluxation unless there are external signs of trauma (eg, swelling, extreme tenderness, ecchymosis), suspicion of elbow or forearm fracture or dislocation, or known mechanism of injury unlikely to result in radial head subluxation. Reduction is done by supination and flexion (traditional reduction technique) or hyperpronation technique (pronation and flexion). The latter requires fewer attempts and has greater succus. In supination and flexion, grasp the palm of the involved hand as if to shake it, and encircle the elbow with the other hand with the thumb placed over the radial head. Fully supinate the arm in one quick deliberate motion while applying gentle longitudinal traction and in a continuous motion flex the elbow to the shoulder. For hyperpronation, apply gentle longitudinal traction, and place the forearm in hyperpronation and then flex the elbow. Most often an audible or palpable pop or click is felt by the thumb lying over the radial head as the annular ligament is freed from the joint and this signals successful reduction. If no click is heard or felt, attempt reduction again in 15 minutes. After a successful reduction, no treatment, radiographs, or immobilization is required.