Describe the radiological principles behind diagnosing and describing fractures

Question 1

Which arrow is indicating soft tissue swelling?

Answer 1

the yellow one

Question 2

How would you describe the position of this fracture?

Answer 2

Impacted

Question 3

What are 5 radiographic signs of a fracture seen on the bone?

Answer 3

1. lucent lines
2. sclerotic lines
3. cortical breach
4. disruption of trabeculae
5. change in bony contour

Question 4

What is trabecula and trabecular patterns?

Answer 4

Trabecula is a supportive and connective tissue element which form in cancellous bone.

The trabecular pattern of growth follows the course of stress lines along the bone

Question 5

What radiographic sign of a fracture are these arrows indicating?

Answer 5

a cortical breach

Question 6

What causes lipohaemarthrosis?

Answer 6

the collection of fat and fluid (blood) within the joint usually following trauma.

the blood cells settle on the bottom, creating a fluid (dark) line

Question 7

What is the minimum amount of fractures you can expect to see in a rigid ring bone?

Answer 7

2

Question 8

How would you describe the position of this fracture?

Answer 8

45º valgus angulation

Question 9

What supplementary radiographic sign of a fracture is being indicated by the white arrow?

Answer 9

haemarthrosis

Question 10

What radiographic sign of a fracture are these arrows indicating?

Answer 10

sclerotic lines

Question 11

How would you describe the path of this fracture line?

Answer 11

longitudinal

Question 12

How would you describe the position of this fracture?

Answer 12

Posterior/dorsal angulation

Question 13

When is CT used to image bone trauma, what is the advantage, and why does it have this advantage?

Answer 13

• complex fractures
• easier to define complex bony structures
• due to ability to slice the data in any plane

Question 14

What radiographic sign of a fracture is this arrow indicating?

Answer 14

lucent line

Question 15

What paired bones are considered ring bones?

Answer 15

radius + ulnar

tibia + fibula

Question 16

How would you describe the path of this fracture line?

Answer 16

spiral

Question 17

How can an x-ray suggest an elbow fracture, if the fracture line isn’t visible?

Answer 17

• elevated anterior fat pad
• presence of any posterior fat pad

Question 18

How would you describe the position of this fracture?

Answer 18

anterior angulation

Question 19

How would you describe the path of this fracture line?

Answer 19

oblique

Question 20

How would you describe the position of this fracture?

Answer 20

Varus angulation

Question 21

What are 3 supplementary radiographic signs of a fracture?

Answer 21

1. haemarthrosis
2. lipohaemarthrosis
3. soft tissue swelling

Question 22

Look at these two x rays. Which X-ray demonstrates knee effusion, and which x-ray demonstrates lipohaemarthrosis?

Answer 22

left - knee effusion

right - lipohaemarthrosis

Question 23

What are sclerotic lines and how are they caused by fractures?

Answer 23

• white lines due to lack of x-ray absorption
• when fracture fragments are impacted and the bony trabeculae overlaps to form lines 2x the density of bone

Question 24

What is a dislocation?

Answer 24

2+ articular surfaces are no longer lined up

Question 25

Asides from 2 radiographic projections, what else needs to be x-rayed when paired bones are injured?

Answer 25

the joint above the joint below

Question 26

What is haemarthrosis?

Answer 26

any fracture that extends into a joint

Question 27

How many radiographic projections do you need to image bone trauma?

Answer 27

minimum 2, taken at 90º to eachother

Question 28

When is MRI used to view fractures and what is the benefit of it?

Answer 28

* for acute fractures * easy t see the haemmorhage and odema caused by fracture

Question 29

What are lucent lines and why can they be seen near fractures?

Answer 29

* they are dark lines caused by too much x-ray beam (air is black bone is white etc.) * due to the fracture fragments separating * or resorption of the bone at the fracture site

Question 30

How would you describe the path of this fracture line?

Answer 30

Transverse

Question 31

How would you describe the position of this fracture?

Answer 31

Displaced

Question 32

What are the 4 paths a fracture line can take, from most stable to least stable?

Answer 32

1. transverse 2. oblique 3. spiral 4. longitudinal

Question 33

What supplementary radiographic sign of a fracture is indicated by this arrow?

Answer 33

lipohaemarthrosis

Question 34

If a joint is partially dislocated, it is called a…

Answer 34

Subluxation

Question 35

When does a cortical breach occur and where is it seen?

Answer 35

* when fractures are displaced * seen in the cortex, perpendicular to the film

Question 36

What 4 terms describe the position of a fracture?

Answer 36

1. angulation 2. displacement 3. impaction 4. foreshortening

Question 37

What is the difference between a simple and comminuted fracture?

Answer 37

simple: 2 fragments comminuted: more than 2 fragments