Nuclear Medicine Imaging
Imaging from the inside out. Radiolabelled dye is injected which highlights osteoblastic activity. Good for imaging bone tumors and very sensitive for picking up areas where there is increased bone repair.
1. Bowing - bone bends but doesn't break
2. Torus (buckle) - slightly bulges out
3. Greenstick - breaks but not completely
Can either be...
1. Simple (clean break)
2. Comminuted (broken into more pieces)
Fracture Description: Orientation
1. Transverse (straight across)
2. Oblique (at an angle)
3. Spiral (oh my god pain)
4. Longitudinal (mostly up and down)
Fracture Description: Displacement and Angulation
You use the distal fragment to describe the fracture.
1. Medial displacement
2. Lateral displacement
3. Apex medial angulation (concave lateral)
4. Apex lateral angulation (concave medial)
Types of Fractures
1. Stress fracture - abnormal stress, normal bone
2. Insufficiency fracture - normal stress, abnormal bone
3. Pathological fracture - bone tumor has weakened site
Glenohumeral Joint Dislocation
9/10 times dislocated anteriorly
1/10 times dislocated posteriorly
Anterior dislocation looks as if it is visibly displaced medially on the X-ray. Posterior looks normal, unless from the back view.
In a fracture, blood will seep into the joint and push the fat pads out of the way.
The key is to look at the anterior fat pad and the posterior fat pad. If the anterior fat pad is pushed away, or the posterior fat pad is visible, this indicates effusion into the joint with a fracture.
A fracture of the proximal third of the ulna with dislocation of the head of the radius.
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S - scaphoid
L - lunate
T - triquetrum
P - pisiform
T - trapezium
T - trapezoid
C - capitate
H - hamate
A fracture of the distal end of the radius in the forearm with posterior displacement of the wrist and hand.
Primary mechanism is fall on outstretched hand (FOOSH).
Avascular necrosis can occur in 15-30% of patients because the scaphoid relies on retrograde blood blow, particuarly the proximal pole.
A fracture of one of the metacarpal bones of the hand. Classically, the fracture occurs transversely across the neck of the bone.