An 8-year-old girl attended the children’s emergency department after having been play-fighting with her younger brother. Her arm had been pushed away by her father during the fight. The girl immediately complained of pain in her arm and refused to move it. Following analgesia and investigation with a plain radiograph of the elbow it was decided to attempt a manipulation procedure with the possibility that this could represent a ‘pulled elbow’ in an unusual age group. Soon after the manipulation the child was completely pain-free and moving her arm fully at the elbow, suggesting a diagnosis of radial head subluxation. The patient demonstrated hypermobility of several joints and she was able to hyperextend her unaffected elbow by >10°. This case highlights the association between radial head subluxation and joint hypermobility.