5: Radiology - X-rays and upper limb Flashcards
What needs to be obtained from a trauma patient before examining an X-ray of their injury?
History and examination info:
Patient age
Mechanism of injury
Site of pain / deformity
Is one view sufficient to diagnose a fracture?
No
Fracture may be invisible in one view, plus bone alignment may be obscured
How many views are usually enough to diagnose a bone fracture?
Two views
Which X-ray views should be used to diagnose a C spine injury?
AP (i.e THE OTHER ONE)
Lateral
Odontoid peg
Which bone fracture of the hand requires four different X-ray views to adequately diagnose?
Scaphoid fracture
Fractures can appear on X-ray as darker areas crossing bone - what are they called?
Lucencies
What does comminution mean?
Fragmentation of bone
What, found around joints, may swell following a fracture?
Soft tissue
Can be seen on X-ray
Fractures may present on X-ray as ___ of bone.
angulations
What term, describing movement of bone away from its original position, may indicate a fracture has occured?
Displacement
What term describes the crushing-together of bones which may have resulted in a fracture?
Impaction
What term describes the ripping away of cortical bone from the rest of the bone, often resulting in fracture?
Avulsion
Which bones, embedded tendons in the knee and hand, are often mistaken for avulsion fractures?
Patella
Sesamoid bones
What can mimic an avulsion fracture?
Sesamoids / patella
Past non-united fractures
Bone ___, as in the spine, can indicate whether a fracture has occurred.
alignment
What is the posterior fat pad sign?
What does it indicate?
What kind of X-ray abnormality is it?
Presence of displaced fat pad posterior to distal humerus
Elbow effusion
Soft tissue abnormality
What is an important indicator of elbow trauma on X-ray?
Posterior fat pad sign
What type of fractures do the bones of children sustain?
Why?
Buckle fractures, bowing, incomplete fractures
Because their bones are softer so they tend not to snap
What may avulse from bones in children’s fractures?
Ligaments
What is a physiological lucency found at the epiphysis of childrens’ bones?
Epiphyseal growth plate
What, in children, may be mistaken for fractures?
Epiphyseal growth plates
In relation to epiphyseal growth plates, what is a Salter-Harris fracture?
Displacement of epiphysis from metaphysis due to fracture
In terms of children’s fractures, what does NAI stand for?
Non-accidental injury
i.e child abuse
It’s important not to ___ ___ after identifying an X-ray abnormality.
switch off
as there is often more than one
If a bony ring is injured, how many fractures would you expect to find?
More than one
Why does foreign material like glass and metal show up on X-ray?
Differing density from bone and soft tissue
What foreign materials are often invisible on X-ray?
Plastic
Wood
What is a pathological fracture?
Fracture resulting from normal stress on WEAKENED skeleton
Pathological fractures are ___ to the mechanism of injury.
disproportionate
What are some causes of skeletal weakening leading to pathological fracture?
Metastatic deposits in bone
Osteoporosis
What shoulder instability is difficult to spot on X-ray?
What view can be used to see it?
Posterior dislocation
Oblique X-ray
