Trauma Radiology

Question 1

What are 3 signs of a calcaneal fracture?

Answer 1

• Loss of Bohler’s angle (made from anterior process, posterior facet and posterior process).
• Loss of normal subtalar articulation
• Abnormal sclerosis

Question 2

An inversion injury may result in?

Answer 2

• Malleolar fractures,
• Talar dome fractures
• Distal tibial fractures,
• High fibular fractures
• Calcaneal fractures
• Base of 5th metatarsal fracture

Question 3

A normal translucent line can be seen in what plane in the 5th metatarsal?

Answer 3

Longitudinal. If there is a horizontal line then this is abnormal

Question 4

What is the normal alignment of the foot?

Answer 4

In an AP view the 2nd metatarsal should line up with cuneiform
In oblique view the medial border of the 3rd metatarsal should line up with the cuneiform

Question 5

What is a lipohaemarthrosis?

Answer 5

Occurs when there is an intra-articular fracture leading to a collection of blood (especially in suprapatellar pouch)

Question 6

What are the different rings and lines which are important to follow in pelvic x-rays?

Answer 6

• 1 large ring (pelvic brim)
• 2 small rings (obturator foramens),
• Ilio-pubic line
• Ilio-ischial line,
• sacral acral line
• Sheldon’s line

Question 7

What is a colles fracture?

Answer 7

Distal radial fracture with dorsal displacement of the fragment. (dinner fork appearance)
Occurs when falling on outstretched hands.

Question 8

What is a smith fracture?

Answer 8

Fracture of the distal radius with volar (palmer) angulation of the distal fragment

Question 9

What is a Barton’s fracture

Answer 9

Fracture of the distal radius with associated dislocation of radio-carpal joint. This is an intra-articular fracture

Question 10

lable the following x-ray (carpal bones)

Answer 10

Scaphoid
Lunate
Triqetral
Pisiform
Trapezium
Trapezioid
Capitate
Hamate

Question 11

What are the approximate inter-carpal distances?

Answer 11

1-2mm

Question 12

What shape of lunate indicates fracture?

Answer 12

Triangular

Question 13

What bones of the wrist should align on the lateral view?

Answer 13

Radius, lunate and capitate

Question 14

How can you detect an occult fracture?

Answer 14

Repeat x-rays, isotrope bone scan, CT or MRI

Question 15

What is at risk from a supracondylar fracture?

Answer 15

Brachial artery

Question 16

What fat pads of the elbow are abdnormal?

Answer 16

Posterior fat pad is always abnormal. If the anterior fat pad is displaced then that is abnormal

Question 17

What is the anterior humeral line?

Answer 17

ON lateral x-ray. if you draw a line down the anterior margin of the humerus then 1/3rd of capitellum should lie anterior to the line. If not then it suggests a supracondylar fracture

Question 18

What is the radio-capitellar line?

Answer 18

If you draw a line from the center of the radius it should pass through the capitella

Question 19

What are the signs of a posterior dislocation

Answer 19

Humerus is symmetrical and round with a ‘light bulb’ appearance.
Consider if history of epilepsy or electric shocks

Question 20

What is the normal appearance of the acromioclavicular joint?

Answer 20

The undersurface of the acromion and clavicle should be lined up

Question 21

WHat are the intracapsular hip fractures?

Answer 21

Subcapital, transcervical and basicervical