Imaging of fractures on Xray, CT and MRI.pptx

radiology

1. Imaging of fracture.

2. Objectives Fracture Different imaging modalities Facial fractures Spine fractures Upper limb fractures Lower limb fractures

3. Fracture It is a break in the continuity of a bone. Etiology : 1. Trauma 2. Pathology 3. Stress ( Chronic repetitive injury)

4. Types of Imaging modalities X-rays : Primary tool for diagnosing fractures. CT Scans : Provides detailed images for complex fractures. MRI : Useful for detecting soft tissue involvement. Ultrasound : Used in pediatric and stress fractures.

5. Facial fractures

6. Nasal fracture M/C facial fracture Clinical presentation: h/o blow over nose Epistaxis Deformity of nose.

7. Orbital floor fracture D/t blow over orbit (fist fight) Clinical presentation: pain and swelling . Diplopia: d/t entrapment of extra ocular muscles between fragments.

8. Tear drop sign and black eye brow sign.

9. Tripod fracture Aka tri-malar or zygomatico - maxillary fracture.

10. Spine fractures

11. Jefferson fracture Burst fracture of Atlas(C1). Mechanism of injury: 1. Fall from height, landing on head. 2. Fall of heavy weight on head.

12. Hangman fracture Seen in judicial hanging. No spinal cord compression is seen due to large spinal canal space at C2.

13. Clay Shoveler’s fracture Aka coalminer’s/root puller’s fracture. Fracture of spinous process of cervical vertebrae (C7) is seen d/t increase in pull force of rhomboid/trapezius muscle.

14. Chance Fracture Horizontal splitting fracture of vertebrae from anterior to posterior involving spinous process, pedicle and body. Mechanism of injury : Seatbelt injury ( Hyperflexion of spine).

15. Compression fracture Aka wedge / grandma fracture. Associated with osteoporosis. M/C site: Lumbar / dorsal / dorso -lumbar junction.

16. Burst fracture Bursting of vertebrae. Neurological compression d/t postero -superior fracture fragment.

17. Spondylolysis and spondylolisthesis Fracture of pars interarticularis . Fracture of pars interarticularis + Anterior displacement of body.

18. Upper Limb fractures

19. Acromio -clavicular joint dislocation Ligaments injured: 1. Acromio -clavicular ligament. 2. Coraco -clavicular ligament.

20. Shoulder Dislocation Anterior : m/c type Subcoracoid : m/c type of anterior dislocation. Complications : 1. Recurrence 2. Axillary nerve injury Recurrent anterior shoulder Dislocation : 1. Bankart’s lesion 2. Hill- Sach’s lesion

21. Posterior shoulder Dislocation Light bulb sign / Tennis racket appearance. Triple E syndrome: B/L posterior locked fracture dislocation of shoulder. Epilepsy Extreme trauma Electric shock

22. Humerus fracture 1.Holstein Lewis fracture: Fracture shaft of humerus involving radial groove Injury to radial nerve : wrist drop. 2. Supracondylar fracture: M/C fracture around elbow in children. M/C nerve injured is Anterior interosseous nerve. M/C artery injured is Brachial artery. M/C complication is malunion .

23. Hemarthrosis at elbow Bleeding in joint : High probability of intraarticular fracture. In X ray it appears as fat pad outside the joint without any fracture/dislocation.

24. Monteggia and Galeazzi fracture

25. Colle’s fracture Extra-articular fracture of distal radius Clinical presentation: Elderly patient. Fall on outstretched hand. Pain at radial aspect of wrist. Swelling Complication: Dinner fork deformity

26. Barton’s and volar barton’s fracture

27. Scaphoid fracture M/C carpal bone fracture. M/C site : waist of scaphoid. Clinical presentation: Young patient Fall on outstretched hand. Pain at radial aspect of wrist. Tenderness at anatomical snuffbox. Investigations: X-ray: Not seen on X-ray CT-scan: IOC Complication: AVN

28. Scapho -lunate Dissociation Scapho -lunate ligament rupture leading to widening of joint space. Terry Thomas sign or Madonna sign.

29. Lunate and perilunate Dislocation

30. Bennett Fracture Intracapsular fracture of proximal end of 1 st metacarpal. Unopposed pull by Abductor pollicis longus tendon that inserts on distal fracture fragment, aggravates the fracture. Comminuted Bennett fracture is Rolando’s fracture.

31. Boxer’s Fracture Mechanism of injury: Forceful punch to the wall leading to fracture shaft of metacarpal. M/C : 2nd and 3rd metacarpals.

32. Gamekeeper/Skier’s Thumb fracture Avulsion fracture of ulnar collateral ligament at proximal end of thumb at metacarpophalangeal joint. Mechanism of injury: outward pull of thumb.

33. Lower limb fractures

34. Fracture neck of femur( intracapsular ) Clinical presentation: Elderly patient. H/O fall. Unable to get up. Pain at hip. Helpless attitude of leg. Complication : AVN

35. Inter-trochanteric fracture Extracapsular fracture. Fracture line from greater to lesser trochanter. No risk of AVN.

36. Patellar fracture Transverse fracture: m/c type.

37. Pott’s fracture Aka Bimalleolar / Dupuytren’s fracture. Fracture involves distal end of tibia and fibula.

38. Aviator’s fracture Fracture neck of talus. D/T sudden forcible dorsiflexion of foot.

39. Lover’s fracture Fracture of calcaneum . D/t fall from height and landing on feet.

40. Jones fracture Fracture at distal end of 5 th metatarsal beyond tuberosity.

41. Pseudo-Jones fracture Aka Dancer’s fracture. Fracture at tuberosity of proximal end of 5 th metatarsal. Avulsion fracture of peroneus brevis tendon.

42. Thank you.......