General Principles of Trauma X Ray Interpretation

Question 1

what 3 views can be used to view the cervical spine on imaging?

Answer 1

AP
lateral
odontoid peg

Question 2

what 3 views can be used to view the scaphoid bone on imaging?

Answer 2

AP
lateral
two obliques

Question 3

what is an avulsion fracture?

Answer 3

an injury to the bone in a location where a tendon or ligament attaches to the bone

Question 4

what is an impaction fracture?

Answer 4

A bone fracture in which one of the fragments is driven into another fragment

Question 5

what is a displacement fracture?

Answer 5

the bone snaps into two or more parts and moves so that the two ends are not lined up straight

Question 6

what is a comminuted fracture?

Answer 6

bone is in many places

Question 7

what is an angulated fracture?

Answer 7

normal axis of the bone has been altered such that the distal portion of the bone points off in a different direction

Question 8

what things on x ray can mimic an avulsion fracture?

Answer 8

sesamoid bone
accessory ossification
old non-united fracture

Question 9

where on the upper limb can you see fat density quite clearly?

Answer 9

anterior to distal humerus

Question 10

what is the posterior fat pad sign?

Answer 10

displaced fat pad visible posterior to distal humerus

Question 11

when will you get a positive posterior fat pad sign

Answer 11

if an elbow effusion is present

usually after trauma

Question 12

how are children’s bones different from ours in terms of injury?

Answer 12

tend to bow or bend rather than snap

Question 13

is avulsion of soft bony attachments more common in adults or children?

Answer 13

children

Question 14

weakest part of a developing bone?

Answer 14

growth plate

Question 15

other word for growth plate?

Answer 15

physis

Question 16

what can a distal femoral fracture indicate?

Answer 16

twisting force

Question 17

what is a bony ring?

Answer 17

bones and joints form rings to help share the transmission of force and increase strength

Question 18

give an example of a bony ring?

Answer 18

spinal canal
pelvis
forearm
lower leg

Question 19

why do you usually see more than one fracture in a bony ring?

Answer 19

a single fracture would disrupt the other side of the ring thus causing another fracture/dislocation (imagine snapping a polo mint)

Question 20

what needs to happen before a foreign body can be seen on an x ray

Answer 20

it needs to be different in density to the surrounding tissues

Question 21

can you see plastic on x ray?

Answer 21

no

Question 22

can you see wood on x ray?

Answer 22

no

Question 23

when should you suspect a pathology in a fracture?

Answer 23

if the bony abnormality seems out of proportion to the mechanism of injury

Question 24

what kind of skeletal weakening would a malignancy cause?

Answer 24

focal

Question 25

what kind of skeletal weakening would a metabolic bone disease cause?

Answer 25

diffuse

Question 26

who tends to get a colles fracture?

Answer 26

elderly person with osteoporosis

Question 27

who gets a radial buckle fracture?

Answer 27

child with soft bones

Question 28

who gets scaphoid fracture?

Answer 28

young male

Question 29

clinical presentation of a scaphoid fracture?

Answer 29

pain in anatomical snuffbox

Question 30

what kind of fracture is a colles fracture associated with?

Answer 30

ulnar styloid fracture

Question 31

what does a bennett’s fracture typically involve?

Answer 31

articular surface of the first metacarpal base