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MSK-FX-UE Flashcards

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1
Q

What is req in a shoulder series X Ray?

A
  1. AP- ER exposed G. tuberosity.
  2. AP- IR G.tuberosity less exposed.
  3. Y- scapula view.
  4. DDX dislocations. Axillary- Dislocation, glenoid,
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2
Q

What is the special view of the glenoid?

A

AP oblique

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3
Q

WHat is showing In the Y trans scapular view?

A
  • Top of Y is coracoid process and scapular spine.
  • Bottom is scapula body
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4
Q

What is DX of humerus is ER and inferior to glenoid?

A

ANT dislocation. MC. Pt. fixed in ER, AB

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5
Q

Pt is in ER from MVA, holding arm in ADD, IR, cannot ER. Xray shows humeral head even lined up with glenoid?

A
  • POST Dislocation.
  • NO G. Tuberosity
  • ***Hard to tell, consider CP of Pt..
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6
Q

What can be used to determine dislocation on Y view?

A
  • ANT- humeral is MEDIAL to Y
  • POST- humeral head is LATERAL to Y
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7
Q

What can be seen on Axillary view, rare for Dislocations?

A
  • POST-Humeral head is far from coracoid, and inferior to glenoid.
  • ANT- Humeral head overlaps coracoid
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8
Q

What is cond/XRay if pt is in a MVA with arm ABD fixed?

A

Luxatio Erecta- humerus severely inferior to glenoid fossa

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9
Q

What complication is from multiple dislocation, where the humeral head is impinged under ant glenoid rim leading to impaction FX on posterolateral humeral head?

A

Hill Sachs Fx

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10
Q

What can occur post reduction of dislocation on the glenoid rim?

A

BANKART FX. Labrum Tear

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11
Q

what are secondary injuries from mechanism of most dislocation?

A
  1. Avulsion of tuberosity RTC.
  2. Jt instability.
  3. Axillary nerve. ALWAYS check neurological
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12
Q

What is LC FX from direct impact, least problematic d/t 2/2 injuries in lungs where you must order a CXR, CT later, and Y view?

A
  1. Scapula FX- ALWAY GET CXR ASAP. Body MC.
  2. Risk Hemi, Pneumothorax, Failed Chest.
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13
Q

What is MC location of clavicle fX w/ what views?

A
  1. Middle 1/3.
  2. Distal 1/3 Elderly.
  3. AP and ANGled -15deg
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14
Q

What is used to determine 4 types of AC separation?

A
  1. SAND BAG wt bearing view-
  2. Type 1 partial tear,
  3. Type 2 Widening
  4. Type 3 AC and CC ligament.
  5. Type 4 impaction
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15
Q

What mm determine Type 2 vs Type 3?

A

>8mm vs >13mm

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16
Q

Describe caution of FX at humeral neck?

A

Surgical neck axillary blood supply AVN.

MC -impaction, comminuted, shortened

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17
Q

What views are reQ for elbow to the NORMAL Fig 8?

A

Lateral-90deg flexed handshake. Fig 8-capitelulm and trochlear bottom of 8, condyles superimposed

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18
Q

What views are reQ for elbow to seen the condyles?

A

Med. Oblique

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19
Q

What views are reQ for elbow to seen radiocapitellar?

A

Lateral Oblique

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20
Q

What views are reQ for elbow to radial head?

A

Capitellum view- Fig 8

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21
Q

Describe the fat pad sign and what it indicates?

A
  1. Hemarthrosis.
  2. Lucent -ANt. fat bad distal bicep-Normal
  3. FX= extended.
  4. ANY Posterior fat pad= FX
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22
Q

What is indicated if the Ant humeral and Radiocapitellar line don’t bisect the middle 1/3 capitellum?

A

FRACTURE

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23
Q

What is MC common sublet elbow FX in adults?

Study These Flashcards
A

Radial head. USE approach

    1. AABC
    1. Fig 8
    1. Fat pad
    1. Ant humeral and Radiocapitellar Line bisect
    1. Humer, Olecranon, Ulna
24
Q

What accounts for 60% of FX in kids in the elbow?

Study These Flashcards
A

Supracondylar FX

25
For kids what is important not to confuse in bones FX?
Epiphyseal plate, ossicles, coronoid, medial condyles, olecranon etc. LOOK for alinement and fat pad
26
What are MC dislocations?
1. fingers 2. shoulder 3. elbow- Kids #1. 90% posterior, HYPEREXT. Consider FX ALWAYS Check vascular and nerves
27
What is direct blow to ulna in defensive posture?
Nightstick FX
28
What is a Fracture of ulna and radial head dislocation?
1. Monteggia 2. FX-UNSTABLE surgery. 3. Radial head ANT dislocation
29
What is distal 1/3 radial shaft FX w/ distal ulnar dislocation?
Galeazzi Ulna-out at radioulnar and carpal ulnar jt. UNSTABLE
30
What is mnemonic for carpals?
Some lover try position- L-M. That they can't handle Trapezium- THUMB
31
For FOOSH FX what should been observed in carpals and radius?
Carpal row alignment. Intra Articular Radial FX
32
What view will you see in a FX on the radius during a FOOSH?
Oblique radial ulnar fX
33
Describe Distal Radius FX angulations?
LATERAL views- Colles- Angle Dorsal/POST, dinner fork, humpback
34
Which nerve should be evaluated?
Median
35
What is MC FOOSH injury?
Colles FX, also check Ulnar styloid
36
What is a SMith's FX?
Distal Ventral/ANT radius FX- LATERal view DISTAL angulation\*
37
What is volar/dorsal BUT with INtra-articular FX dislocstion?
Barton
38
What can be seen in an intraarticular radial styolid fx?
Chauffeur/Huttchens- lunate scaphoid widen. NO angulation
39
In a Lunate load fx, punch, what is seen?
Hyperdense at MEDIAL distal radius, with widening.Intraarticular
40
What is MCC carpal fx with risk of avasular necrosis?
* Scaphoid (NAav FX)- waist of bone HIGH proximal bone risk. * view in ULNAR DEVIATION
41
What is the 2nd MC FX in hand best seen in which view?
Triquetrum- most dorsal bone FX- LATERAL view
42
What will a lunate dislocation look like on AP and LATERAL view?
* AP- Triangle, arches gone, Scaphoid shortened * LATERAL- spilled teacup. * UNSTABE- median nerve
43
What is seen on a LATERAL where the luncate is in postion but others are not?
Perilunate Dislocation- 3x MC. Capitate and MC Dislocated- check scaphoid and median nerve
44
What is seen on PA with perilunate?
crowded carpals
45
What is occurring in scapholunate Dissocation?
Extra widen space- Scaphoid rotates on AP view creating space
46
What is defined has Boxers fX?
4th or 5th metacarpal NECK FX. 5th digit may rotate medially
47
Are true Boxer fX shaft and intra articular?
NO!
48
What is a Bennetts FX?
* Intra Articular FX dislocation of 1st MCP jt. * Abductor pollicis longus pulls MC downward avulsing off
49
What is a Rolando FX?
Comminuted MC intra articular base of thumb
50
What is easy to miss in hyperextension phalanx injury?
Volar plate avulsion PIP jt- UNSTABLE
51
What is a mallet finger?
* Avulsion FX of DIP at extensor tendon-untreated * REFER ORTHO
52
What is Boutonniere finger?
HYPERFlex PIP d/t central slip and HYPEReXT d/t lateral bands. MC RA pts
53
What is swan's neck finger?
Fixed EXT of PIP and FLEXED DIP- MC Autoimmune
54
what can occur at base of proximal 1st phalanx?
Gamekeeper thumb- UCL avulsion FX
55
What is important about distal phalanx fracture?
1. Tuft- tip FX repair, ABX- NONURGENT. 2. Distal NECK- OR URGENT

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