December 8, 2015 - Radiology II

Question 1

Pubic Rami Fracture

Answer 1

Common mimic of a broken hip.

Usually broken in two places (think of a pretzel)

Question 2

Diastasis of Symphysis Pubis

Answer 2

Occurs with significant trauma to the pelvis.

Evaluate closely for diastasis of sacroiliac joints and associated fractures.

Question 3

Hip Anatomy

Answer 3

Acetabelum

Femoral head

Femoral neck

Greater trochanter

Lesser trochanter

Question 4

Subcapital Fracture

Answer 4

Risk of avascular necrosis following a sub-capital fracture. The risk is directly related to the amount of displacement.

Question 5

Hip Dislocations

Answer 5

May occur posteriorly (90%) or anteriorly (10%)

Classic mechanism is an unrestrained occupant in a motor vehicle accident and their flexed knee hits the dashboard with the hip flexed and adducted

Associated with fractures of the posterior rim of the acetabelum.

Question 6

Skyline View

Answer 6

Can be used to assess the patella in the knee.

In particular, you are observing the patellar articular surface and the femoral groove.

Question 7

Lipohemarthrosis

Answer 7

Horizontal beam lateral radiograph.

Indicates an intra-articular fracture. Bood and liquid fat are extreuded from medullary cavity into the joint space.

Question 8

Patellar Fracture

Answer 8

Can occur vertically or transversely.

If vertically, this is less concerning than transversely. If the patella is fractured transversely, tendons attach to the top and bottom and may pull it apart.

Question 9

Segond Fracture

Answer 9

Avulsion fractures of the lateral aspect of the proximal tibia below the articular surface.

Mechanism of injury is internal rotation and varus stress.

Highly accompanied by a tear of the ACL (75-100%) and of the medial and lateral meniscus (66-70%).

Question 10

Trimalleolar Fracture

Answer 10

Occurs when the medial malleolus, lateral malleolus, and posterior malleolus are all broken in an injury.

Question 11

Fifth Metatarsal Fracture

Answer 11

Very common.

Often a stress fracture.

Strong ligaments attach the base of the fifth metatarsal ot the cuboid bone and the fourth metatarsal bone. Because of the strong ligament attachments, it is easier for an individual to break or fracture the fifth metatarsal than to dislocate it.

Question 12

Lisfranc Fracture-Dislocation

Answer 12

Tarsometatarsal fracture dislocation

Mechanism is severe plantar flexion of the foot or “folding” of midfood on the forefoot.