Podcast
Questions and Answers
What is a wedge injury in a patient with osteoporosis?
What is a wedge injury in a patient with osteoporosis?
Crush fracture of a vertebral body so bad, it looks like a wedge.
What is a biconcave injury in a patient with osteoporosis?
What is a biconcave injury in a patient with osteoporosis?
Compression fracture to both the superior and inferior parts of a vertebrae, making it biconcave, along with height loss.
How should you try to identify pelvic fractures?
How should you try to identify pelvic fractures?
Incomplete cortex.
What are the signs of pelvic diastasis (separation)?
What are the signs of pelvic diastasis (separation)?
What is the most common site of pelvic avulsion injury?
What is the most common site of pelvic avulsion injury?
What is a sign of a sacral fracture?
What is a sign of a sacral fracture?
Clavicle fracture typically leads to what displacement?
Clavicle fracture typically leads to what displacement?
How are abnormalities of the acromioclavicular joint determined?
How are abnormalities of the acromioclavicular joint determined?
What ligaments tend to tear in acromio-clavicular displacement?
What ligaments tend to tear in acromio-clavicular displacement?
How should a normal glenohumoral joint appear?
How should a normal glenohumoral joint appear?
What two things will you look for on limb X ray in glenohumeral dislocation?
What two things will you look for on limb X ray in glenohumeral dislocation?
What will make you suspect a posterior humeral dislocation on X ray?
What will make you suspect a posterior humeral dislocation on X ray?
What is the most common site of humeral fracture?
What is the most common site of humeral fracture?
When do shaft fractures of the humerus tend to occur?
When do shaft fractures of the humerus tend to occur?
What is the order in which parts of the elbow ossify?
What is the order in which parts of the elbow ossify?
What are some features of a normal lateral elbow X ray in a 7 year old?
What are some features of a normal lateral elbow X ray in a 7 year old?
What does the raised fat pad sign indicate?
What does the raised fat pad sign indicate?
What does the raised fat pad sign in the absence of trauma history indicate?
What does the raised fat pad sign in the absence of trauma history indicate?
What X ray features may indicate a supracondylar fracture?
What X ray features may indicate a supracondylar fracture?
How is radial head dislocation identified?
How is radial head dislocation identified?
What forearm fractures might you be expecting in different age groups?
What forearm fractures might you be expecting in different age groups?
What is a Colle's fracture?
What is a Colle's fracture?
What is a Reverse-Colle's fracture/Smith's fracture?
What is a Reverse-Colle's fracture/Smith's fracture?
What might a comminuted fracture of the distal forearm appear like?
What might a comminuted fracture of the distal forearm appear like?
Describe how an ulnar fracture leads to radial dislocation, and vice versa.
Describe how an ulnar fracture leads to radial dislocation, and vice versa.
Distinguish between a Torus injury and Greenstick fracture.
Distinguish between a Torus injury and Greenstick fracture.
Why is a lateral view essential in suspected wrist fractures?
Why is a lateral view essential in suspected wrist fractures?
What is the most commonly fractured carpal, and when is X ray indicated to search for it?
What is the most commonly fractured carpal, and when is X ray indicated to search for it?
When do you treat scaphoid fracture?
When do you treat scaphoid fracture?
Triquetrium fracture can only be seen on what view?
Triquetrium fracture can only be seen on what view?
When might you order an oblique view hand X ray?
When might you order an oblique view hand X ray?
What radiographic signs indicate that the carpals may have a dislocation or fracture?
What radiographic signs indicate that the carpals may have a dislocation or fracture?
What is the most commonly damaged carpal ligament?
What is the most commonly damaged carpal ligament?
What bone do the most common wrist dislocations involve?
What bone do the most common wrist dislocations involve?
What are the features of a normal hip X-ray?
What are the features of a normal hip X-ray?
How are proximal femoral fractures classified?
How are proximal femoral fractures classified?
What are the X ray features of a Subcapital Femoral Fracture?
What are the X ray features of a Subcapital Femoral Fracture?
What is the Garden classification?
What is the Garden classification?
What are the features of an intertrochanteric fracture?
What are the features of an intertrochanteric fracture?
What are the features of a subtrochanteric fracture on X ray?
What are the features of a subtrochanteric fracture on X ray?
When is hip dislocation most common, and in what direction does it usually occur?
When is hip dislocation most common, and in what direction does it usually occur?
What are the two main causes of femoral shaft fracture?
What are the two main causes of femoral shaft fracture?
What are the normal findings on an AP knee X ray?
What are the normal findings on an AP knee X ray?
What are the normal findings on a lateral knee X ray?
What are the normal findings on a lateral knee X ray?
When is a Skyline view of the knee indicated?
When is a Skyline view of the knee indicated?
What are some signs of tibial plateau fracture on X ray?
What are some signs of tibial plateau fracture on X ray?
How might a patellar fracture appear on X ray?
How might a patellar fracture appear on X ray?
What are some normal variants of knee anatomy sometimes seen on X ray?
What are some normal variants of knee anatomy sometimes seen on X ray?
Most tibial fractures result from high force impact, but some may be more subtle. Which ones might be more subtle or might not show on X ray initially?
Most tibial fractures result from high force impact, but some may be more subtle. Which ones might be more subtle or might not show on X ray initially?
What will a tibial stress fracture look like?
What will a tibial stress fracture look like?
What view should be done of suspected ankle fractures?
What view should be done of suspected ankle fractures?
What are the main bones and ligaments which may be injured during an ankle fracture?
What are the main bones and ligaments which may be injured during an ankle fracture?
How are lateral (fibular) malleolar fractures classified?
How are lateral (fibular) malleolar fractures classified?
What are the features of a bimalleolar ankle fracture?
What are the features of a bimalleolar ankle fracture?
What are the features of a trimalleolar fracture?
What are the features of a trimalleolar fracture?
What are the features of a Maisonneuvre fracture?
What are the features of a Maisonneuvre fracture?
What fractures tend to be associated with falling from height?
What fractures tend to be associated with falling from height?
What are the standard views for a calcaneal fracture?
What are the standard views for a calcaneal fracture?
What is Boher's angle?
What is Boher's angle?
What are the X ray signs of calcaneal fracture?
What are the X ray signs of calcaneal fracture?
What fracture is identified at the mandible that needs further checking?
What fracture is identified at the mandible that needs further checking?
What is the normal X ray view for examining the mandible?
What is the normal X ray view for examining the mandible?
What sign might be present in mandibular fracture?
What sign might be present in mandibular fracture?
What view may help if you are unsure if there is a fracture near the temporomandibular joint?
What view may help if you are unsure if there is a fracture near the temporomandibular joint?
What are the three views used for C spine injuries?
What are the three views used for C spine injuries?
What is the Open mouth view done for?
What is the Open mouth view done for?
When is CT or MRI indicated in the context of C spine injury?
When is CT or MRI indicated in the context of C spine injury?
What is the systematic approach to assessing C Spine injury?
What is the systematic approach to assessing C Spine injury?
What are the soft tissue findings you expect in a normal C spine X ray?
What are the soft tissue findings you expect in a normal C spine X ray?
Where do you expect to see a corticated ring on spinal X ray?
Where do you expect to see a corticated ring on spinal X ray?
What X ray features will likely occur in a fracture of C1?
What X ray features will likely occur in a fracture of C1?
What X ray features can occur in a fracture of C2?
What X ray features can occur in a fracture of C2?
What is a hangman fracture?
What is a hangman fracture?
Aside from hangman injury, what fracture can occur as a result of extension of the neck?
Aside from hangman injury, what fracture can occur as a result of extension of the neck?
At what vertebral levels do flexion teardrop fractures usually occur?
At what vertebral levels do flexion teardrop fractures usually occur?
What might you see in bilateral perched facets, and what is the cause?
What might you see in bilateral perched facets, and what is the cause?
What would soft tissue in front of C3, 50% the size of the vertebral body maybe indicate, assuming everything else is normal?
What would soft tissue in front of C3, 50% the size of the vertebral body maybe indicate, assuming everything else is normal?
How will a 'clay-shoveler's' fracture show?
How will a 'clay-shoveler's' fracture show?
What view is required in sternal fracture?
What view is required in sternal fracture?
How do you identify a sternal fracture?
How do you identify a sternal fracture?
When is a CXR indicated in the context of rib fracture?
When is a CXR indicated in the context of rib fracture?
What might the CXR of a patient who has sustained rib fracture appear like if complications develop?
What might the CXR of a patient who has sustained rib fracture appear like if complications develop?
What is the best systematic approach to assessing thoracic and lumbar spine X rays?
What is the best systematic approach to assessing thoracic and lumbar spine X rays?
What is the three column model of spinal fractures?
What is the three column model of spinal fractures?
Why must you always assess for other fractures if you find one?
Why must you always assess for other fractures if you find one?
What features will you expect on compression fracture of the spine?
What features will you expect on compression fracture of the spine?
What features might you expect on a burst fracture?
What features might you expect on a burst fracture?
Where are flexion-distraction injuries most common?
Where are flexion-distraction injuries most common?
What X ray features are seen in flexion-distraction injuries?
What X ray features are seen in flexion-distraction injuries?
Study Notes
Clavicle and Acromioclavicular Anatomy
- Clavicle fractures typically lead to inferior displacement of the distal component.
- Abnormalities in the acromioclavicular joint are assessed by malalignment between clavicle and acromion, and inferior displacement of the acromion.
- Coracoclavicular ligaments tend to tear in cases of acromioclavicular displacement.
Glenohumeral Joint Assessment
- Normal glenohumeral joint appearance includes proper alignment in AP view, with the humeral head seated neatly in the glenoid fossa.
- Signs of glenohumeral dislocation include malalignment of glenoid and humeral head surfaces and the humeral head sitting below the coracoid process.
- Posterior humeral dislocation is suspected if there is a widened glenohumeral joint, a light bulb sign, and lack of overlap with the coracoid.
Humeral and Elbow Fractures
- The most common site of humeral fracture is at the surgical neck, typically presenting as a transverse fracture with separation of the greater tubercle from the head.
- Shaft fractures of the humerus often occur in conditions like multiple myeloma or osteosarcoma, visible as lytic lesions.
- The order of ossification in the elbow is CRITOL, occurring between ages 6-12 and fusing in early adulthood.
Joint Effusion and Fracture Indicators
- Anterior fat pad and radiocapitellar line should be present in a normal lateral elbow X-ray of a 7-year-old.
- A raised fat pad sign indicates joint effusion, often from fractures, particularly radial head fracture or supracondylar fracture in children.
- Fracture features include less than one-third of the capitulum lying behind the anterior humerus line indicating a supracondylar fracture.
Wrist and Forearm Fractures
- Radial head dislocation can be identified if the radiocapitellar line does not pass through the capitulum.
- Colle's fracture is characterized by a transverse distal radius fracture with dorsal angulation, while Reverse-Colle's (Smith's) fracture involves palmar displacement.
- Ulnar fractures can lead to radial dislocation due to interosseous ligament connections, often evident by the loss of radiocapitellar line.
Pediatric Fractures and X-ray Views
- Torus injuries present with buckling of bones without complete fractures, while greenstick fractures show partial fractures with buckling.
- Lateral views are vital in suspected wrist fractures to ensure proper alignment of the radius, capitate, and lunate.
- Scaphoid fractures should be suspected with post-traumatic wrist pain, particularly with snuff box tenderness.
Ankle and Foot Injuries
- Ankle fractures are assessed using the ankle mortise view; commonly injured structures include tibia, fibula, and talus.
- Weber classification categorizes lateral malleolar fractures relative to the syndesmosis: A (distal), B (at level), C (above).
- Bimalleolar fractures feature transverse medial and lateral malleolus fractures with joint widening from talus displacement.
Pelvic and Spinal Fractures
- Assess pelvic fractures by looking for incomplete cortex and signs of diastasis between the pubic symphysis and sacroiliac joints.
- Signs of sacral fractures include loss of arcuate lines on X-ray.
- C-spine injuries should be evaluated with a systematic approach (CABSSE) and include lateral, AP, and odontoid views.
Miscellaneous Fractures
- Hangman fractures result from high force extension injuries leading to C2 fractures.
- Flexion-distraction injuries disrupt all three spinal columns and often occur in thoracolumbar junctions.
- Osteoporotic fractures can appear as wedge injuries or biconcave injuries due to vertebral body compression.
General Considerations
- Rib fractures warrant Chest X-ray if complications like hemothorax or pneumothorax are suspected.
- Always check for additional fractures after identifying one in spinal injuries due to high co-morbidity rates.
- Mandibular fractures require checking for possible dislocations or fractures at the temporomandibular joint.
X-ray Techniques
- For sternal fractures, lateral views are required to inspect for cortical discontinuity.
- Normal hip X-rays show Shenton's line uninterrupted and proper alignment in both AP and lateral views.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Description
Enhance your understanding of limb X-ray interpretations with these flashcards. Each card focuses on key concepts such as clavicle fractures, acromioclavicular joint abnormalities, and ligament tears. Perfect for students and professionals in the field of radiology.
