Soft Tissue Signs

Question 1

What are soft tissue signs

Answer 1

Change in normal appearance of soft tissue, indicate presence of injury or pathology

Question 2

3 things we check for when looking at soft tissue

Answer 2

• soft tissue swelling evidence
• disruption of fat planes
• presence of foreign material

Question 3

A fat pad?

Answer 3

A fatty structure within certain joints (e.g elbow) which may act as a cushion to absorb forces generated across the joint

Also Prevent friction between a bone and ligament/ tendon

Question 4

The three soft tissue knee signs

Answer 4

• lipohaemarthrosis
• fluid in supra-patella bursa
• extra- capsular swelling

Question 5

Lipohaemarthrosis ?

Answer 5

Lipo (fat) haem (blood) arthrosis (joint)

Effusion of blood and fat into suprapatellar bursa

Cause = intra- articular fracture when fat and blood from bone marrow is extruded into joint space.

Most commonly seen in knee. Found in shoulder elbow and hip

X-ray = fat fluid level seen with horizontal beam

Question 6

How is fat fluid seen on x-ray

Answer 6

Horizontal beam

Question 7

Extra- capsular swelling?

Answer 7

Localise over injured structure

Swelling in tissue, quite obvious

Question 8

Soft tissue elbow signs

Answer 8

There are 2 fat pads = posterior and anterior

• visible posterior fat pad = always abnormal
• visible anterior fat pad = normal but displaced anteriorly = abnormal

Normally = 2 fat pads remain close to surface of bone and not visible

BUT= joint effusion is present it distends the capsule & displaces the fat pads away from bone

Question 9

Pronator (quadratus) fat pad sign

Answer 9

A square shape muscle on distal forearm that acts to probate the hand

Fat strip that lies in front of pronator quadratus = indication of a fracture, not always reliable

If fat strip seen = draws attention to possibility of future fracture

Question 10

Osteomyelitis

Answer 10

Infection of bone

Symptoms = pain and tenderness over affected area of bone, unwell feeling m,

Treatment = antibiotics or surgery if infection is severe

First suggested by overlying soft tissue oedema at 3-5 days after infection
Bony changes not evident for 14-21 days
Manifest to periosteal elevation& cortical/medullary lucecncies
28 days = 90% abnormality,
30-50% focal bone is necessary to detect lucency on conventional radiography