Imaging the Upper and Lower Limbs

Question 1

What should we see on a shoulder radiograph?

Answer 1

• Clavicle
• Acromio-clavicular (AC) joint
• Scapula
• Gleno-humeral joint
• Upper humerus
  
  • -Rotator cuff

Question 2

What is a Hills-Sachs deformity?

Answer 2

Cortical depression of the postero-lateral aspect of the humeral head, due to anterior dislocation and impact against glenoid.

Question 3

What is a Bankart lesion?

Answer 3

A fracture of the glenoid labrum, due to anterior dislocation and impact against the glenoid.

Question 4

What is important about a scapula fracture?

Answer 4

They are uncommon because they take significant force and may be pathological - check for other injuries, including ribs and lungs.

Question 5

What is important about upper humerus fractures?

Answer 5

• Usually through surgical neck rather than anatomical neck
• Displaces, undisplaced, impacted or comminuted
• Pseudo-dislocation of gleno-humeral joint - humeral head appears inferiorly displaced (actually subluxed) due to haemarthrosis

Question 6

What is important to remember about elbow radiographs?

Answer 6

• Look for the fat pads as evidence of a fracture
• Paediatric fractures are usually supracondylar
• CRITOL
• Anterior humeral and radiocapitellar lines

Question 7

What is the order of elbow ossification?

Answer 7

C - Capitellum
R - Radial head
I - Internal epicondyle
T - Trochlea
O - Olecranon
L - Lateral epicondyle

Question 8

What is a Colles’ fracture?

Answer 8

Fracture of the distal radius in extension, causing dorsal/posterior dislocation of hand and wrist.

Question 9

What is a Smith’s fracture?

Answer 9

Fracture of the distal radius in flexion, causing palmar/anterior dislocation of hand and wrist.

Question 10

What is a Lisfranc fracture?

Answer 10

Injury where one or more of the metatarsals are displaced from the tarsus.

Question 11

What is a stress fracture?

Answer 11

A small crack within a bone, caused by repetitive force.