Upper Limb Trauma Imaging Flashcards
what views are taken of the cervical spine?
AP
lateral
odontoid peg
what views are taken of the scaphoid?
AP
lateral
2 obliques
what type of fracture is known as a boxers fracture?
angulation
all fractures look almost the same, true or false?
false
many different appearances and types of fractures
can be depend on mechanism of injury
what is an avulsion fracture?
fracture where a tendon or ligament pulls of a piece of bone
what can mimic an acute avulsion fracture?
sesamoid bones
accessory ossification centres in children
old non-united fractures
- all have a completely corticated contour
what aspects of the upper limb can be used to assess bony alignment?
acromioclavicular glenohumeral elbow - radio-capitellar - humero-capitellar lateral wrist - between radius, lunate and capitate (should sit on top of each other)
what can cause a displacement of the ulna?
supracondylar fracture
what does the lunate look like?
cashew nut
where can fat density be seen on a normal x ray and what does this look like?
usually sits in front of the elbow
looks darker
what does a posterior fat density pad at the elbow indicate?
effusion
how do childrens bones differ to adult?
more soft so bend and bow rather than snap or splinter dracture
common types of fracture in children?
buckle fracture
greenstick fracture
what can happen to ligaments in children?
ligaments or tendons can avulse their soft bony attachments
they pull the bone out of alignment
what is the weakest part of developing bone?
growth plate so prone to injury
- can be complicated by growth deformity
where is the epiphysis in normal bones and what can displace this?
centred on the metaphysis
can be displaced by fracture
what can physes be confused with?
fractures
what must be kept in mind with young children if injury doesn’t match history?
non-accidental injury
what is a salter harris fracture?
fracture involving epiphyseal growth plate
usually in children
what is a bony ring?
many bones from rings to help share the transmission of force and increase strength
- spinal canal
- pelvis
- forearm and lower leg
what is the significance of bony rings in terms of fracture?
difficult to fracture a ring in only one place
(imagine trying to break a polo mint in only one place)
therefore if you see one injury in a bony ring there is likely to be another so must look for it
what foreign materials can be seen on X ray?
metal and glass
(not wood and plastic)
must be more dense than the soft tissue
what can cause large fracture from a trivial njury?
skeletal weakening
- focal or whole skeleton
likely fracture to occur in elderly osteoporotic lady if falling on outstretched hand?
colles fracture
how many carpal bones should there be?
8
what fracture would occur from falling on an outstretched hand in a young child?
buckle fracture
what fracture would occur from an outstretched hand in adult man?
scaphoid
post menopausal woman falling on outstretched hand?
surgical neck of humerus fracture
which shoulder dislocation is more difficult to see?
posterior
obtain oblique view as well to see properly
what indicates a supracondylar fracture?
humero-capitellar malalignment
why is a scaphoid fracture difficult?
can be very difficult to see (almost invisible)
risk to blood supply - can cause avascular necrosis and eventually lead to secondary OA
what is a bennets fracture?
involves articular surface of the first metacarpal base
