My 4 year-old daugther has arthrogryposis in her upper limbs. Both arms have contractures and her shoulder are internally rotated. Her arms are in extention, wrist are in flextion and she can't supinate. She fell straight forward with all her weight on her arms extended. She has swelling and a lump right below the elbow caspule. They did x-ray as best as they could. Didn't see a fracture. Now it's been 24 hours and she is still in pain, won't use the arm and cries if you try to touch. Local hospital don't know what to do. So what do I do. The hospital she goes to doesn't have a ER or a MRI.