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MK SR INDEX CASES ACUTE CARE > Acute Radiology > Flashcards

Acute Radiology Flashcards

1
Q

Fracture Terminology

- Open/Closed

A

• Open/Closed : Communication with skin

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2
Q

Fracture Terminology

- Simple/Comm

A

• Simple/Comm. : Fragments 2 or more

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3
Q

Fracture Terminology

- Complete vs Incomplete

A

• Complete/Incomplete: all cortex disrupted

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4
Q

Fracture Terminology: Displacement

A

Apposition and alignment defined in relation to
distal fragments:

Displacement (e.g., medial lateral, posterior,
anterior)

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5
Q

Fracture Terminology:

Angulation

A

Apposition and alignment defined in relation to
distal fragments:

Angulation (e.g., medial, lateral, posterior,
anterior)

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6
Q

Fracture Terminology:

Overriding

A

Apposition and alignment defined in relation to

distal fragments: overlap of fragments

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7
Q

Fracture Terminology:

Distracted

A

Apposition and alignment defined in relation to

distal fragments: separated fragments

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8
Q

Fracture Terminology: Green Stick Fracture

A

Break of one cortical margin

Only with intact periosteum due to tension on soft growing bone

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9
Q

Fracture Terminology: Torus Fracture

A

Buckling of cortex due to compression

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10
Q

Fracture Terminology: Pathologic Fracture

A

Fracture at site of preexisting osseous abnormality

Cause: tumor,osteoporosis, infection,metabolic disorder

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11
Q

Fracture Terminology: (Fatigue) Stress Fracture

A

Fractures produced as a result of repetitive prolonged muscular action on a bone that has not accommodated itself to such actions, activity-related pain abating with rest

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12
Q

(Fatigue) Stress Fracture Features on XR

A

X-Ray:
• 15% sensitive in early fractures, increasing to 50% on follow-up)
• Subtle blurring of trabecula margins
• Sclerotic band (due to trabecular compression usually perpendicular cortex)

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13
Q

Fracture Terminology: Salter Harris

A

Epiphyseal plate Injury

Types:
I) S: Slipped
II) A: Above
III) L: Lower
IV) T: Through
V) R: Rimmed
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14
Q

Salter Harris Types:

Slip through physis+ extending
through metaphysis separating a triangular fragment (“corner sign”)

A

Type II: 75% (most common)
• Location: distal radius (33-50%), distal tibia, fibula, phalanges
• Prognosis: good, may result in minimal shortening

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15
Q

Salter Harris Types:

Line of fracture: vertically/ obliquely through epiphysis to periphery of physis

A

Type III: 8%
• Intra-articular fracture
• Location: distal tibia,distal phalanx.
• Types III & IV are more prone to chronic disability

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16
Q

Salter Harris Types:

Fracture involves metaphysis+
physis+ epiphysis

A

Type IV: 10%
• Prognosis: guarded (may result in deformity)
• Types III & IV are more prone to chronic disability

17
Q

Salter Harris Types:

Crushing injury often associated with: fracture
of adjacent shaft

A 
Type V: 1%
• Crushing injury with injury to
vascular supply
• Location: distal femur, proximal tibia
• No intermediate radiographic finding
• Type V associated with growth disturbances and has a poor functional prognosis
18
Q

Fracture Terminology: Bennett Fracture

A

Mechanism: forced abduction of thumb
• Intra-articular fracture dislocation of base of 1st
metacarpal
• A small fragment of 1st metacarpal continues to articulate with trapezium

19
Q

Fracture Terminology: Boxer’s Fracture

A

Fracture of the MCP neck (most commonlv 5th MCP)

with volar angulation and often external rotation of the distal fragment

20
Q

Fractures: Most common carpal fracture

A

Scaphoid Fracture

Most common fracture of carpus (90%)

Mechanism: Fall on outstretched hand in young adults.

Locations:
Waist 70%
Proximal pole 20%
Distal pole, 10%

21
Q

Fracture Terminology: Mallet Finger

A

Baseball (mallet) finger
• Dorsal Avulsion of extensor mechanism
• DIP flexion with or without avulsion fragment

22
Q

Fracture Terminology: Barton’s Fracture

A
  • Intra-articular fracture of the volar or dorsal margin of the distal radius.
  • The carpus usually follows the distal fragment.
  • Unstable fracture requiring open reduction and internal fixation and/or external fixation.
23
Q

Fracture Terminology: Chauffer Fracture

A

Triangular fracture of radial styloid process.

24
Q

Fracture Terminology: Colle’s Fracture

A
  • Extra-articular fracture (in contradistinction to Barton’s fracture)
  • Distal radius is dorsally displaced/angulated
  • Ulnar styloid fracture 50%
  • Foreshortening of radius
25
Q

Complications of Colle’s Fracture

A

Median, ulnar nerve injury, OA

26
Q

Fracture Terminology: Galeazzi Fracture

A

Fracture of ulnar shaft+ dislocation of radial
head

• Radial shaft fracture (most commonly) at junction of distal to middle third with dorsal angulation
• Dislocation of distal radio-ulnar joint
• Ulnar plus variance ( radial shortening) implies complete
disruption of interosseous membrane (instability of radio-ulnar joint)

27
Q

Fracture Terminology: Monteggia Fracture

A

Mechanism: direct blow to the forearm

Anteriorly angulated proximal ulnar fracture with Anterior dislocation of radial head

Reverse Monteggia: Radial head displaced posteriorly, Dorsally angulated proximal ulnar fracture

28
Q

Fracture Terminology: Fat Pad Sign

A

• Displacement of anterior fat pad indicative of elbow fracture
• Posterior fat pad
Indicating elbow joint effusion with (supracondylar/lateral condylar /
proximal ulnar or radial fractures)

29
Q

Fracture Terminology: Elbow Lines

A

Alignment:
A) Radio-Capitellar Line
B) Anterior Humeral Line.

30
Q

Treatment Radial Head Fracture

A
  • No displacement: splint, cast
  • More than 3 mm displacement on lateral view: open reduction and internal fixation
  • Comminuted: exicision of radial head
31
Q

Radiographic Features of Radial Head Fracture

A
  • Positive fat pad sign
  • Fracture line may be difficult to see on
  • standard projections.
32
Q

Radiographic Features of Humeral Head Fracture

A

• Fracture lines according to Neer classification
• Pseudosubluxation: inferior displacement of
humeral head due to hemarthrosis

33
Q

Site of clavicle fractures

A
  • Lateral third: 15%
  • Middle third: 80%
  • Medial third: 5%
34
Q

Dislocation vs subluxation

A

Dislocation: separation of articular surface of glenoid fossa and humeral head that will not reduce spontaneously.

Subluxation: transient incomplete separation that reduces spontaneously

35
Q

Shoulder Dislocation is divided into two large categories:

A
  • TUBS (Traumatic unidirectional Bankart requires surgery)

* AMBRI ( A traumatic multidirectional bilateral recurrent instability)

36
Q

Anterior Shoulder Dislocation: Radiographic findings

A

• Humeral head lies inferior and medial to glenoid

Two lesions can occur as humeral head
strikes the glenoid:
• Hill-Sachs lesion (posterior-superior and lateral) of humeral head, (best seen on Ap view with internal rotation)
• Bankart lesion (antero-inferior) of glenoid (may require CT)

37
Q

Posterior Shoulder Dislocation: Radiographic findings

A
  • Humeral head lies superior to glenoid
  • Trough sign: compression fracture of the anterior humeral surface
  • Posterior displacement is best seen on the axillary view.
  • Light bulb sign: a circular appearance of the humeral head, arm fixed in internal rotation.
  • Rim sign (66%) = distance between medial border of humeral head+anterior glenoid rim >6 mm
38
Q

General indicators of cervical spine fracture instability

A
  • more than one vertebral column involvement
  • increased or reduced intervertebral disc space height
  • increased interspinous distance
  • facet joint widening
  • vertebral compression greater than 25%
39
Q

cervical spine fractures: 4 major mechanisms

A
  • Flexion
  • Extension
  • Rotational and shearing, each associated with certain fracture patterns

MK SR INDEX CASES ACUTE CARE (42 decks)

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