Trauma Imaging

Question 1

What might immobility through lower limb injury lead to?

Answer 1

dehydration and starvation
DVT or pulmonary embolus
pneumonia

Question 2

What are limitations of X-ray and what are solutions?

Answer 2

• Assessment of fractures by x-ray is sometimes difficult due to overlapping anatomical structures (CT is good for this)
• Some fractures are impossible to see because:
  the standard x-ray projections do not show them
  as they are undisplaced (MRI is helpful)
• Soft tissue injuries are not shown by x-rays (Ultrasound can be good for superficial structures like tendons, MRI can show deeper structures or within joints)

Question 3

What is impacted fracture and what are common sites of impacted fracture?

Answer 3

femoral neck
tibial plateau
calcaneus

Question 4

How is imaging different for high energy vs low energy pelvic ring fracture?

Answer 4

For high energy fractures:

For low energy fractures:

Question 5

What imaging modalities are good for pelvic soft tissue injury?

Answer 5

Superficial injury – Ultrasound would be good

But pelvic injury is more likely deep – MRI would be a good choice and definitely more thorough assessment

Question 6

What are complications that would add to complexity of hip dislocation?

Answer 6

Femoral head avascular necrosis and early OA

Question 7

What are considerations when imaging knee injuries?

Answer 7

Little avulsion fractures of small bone fragments

Question 8

What does a standard trauma x-ray series comprise?

Answer 8

AP
horizontal beam lateral

Question 9

Which vessel might be affected with knee dislocation?

Answer 9

Popliteal artery

Question 10

What is tibial plateau fracture and what is a usual cause?

Question 11

What knee injuries can MRI show that might not be visible in X-ray?

Answer 11

• meniscal tears
• cruciate, collateral or other capsular/ligamentous injuries
• hyaline cartilage damage
• subtle fractures

Question 12

What should extensor mechanism injuries imaging be done with?

Answer 12

Ultrasound

Question 13

What is a Maisonneuve fracture? How does it usually present and what is something to keep in mind?

Question 14

What are common sites affected in ankle fracture and what is something to keep in mind?

Answer 14

Medial, lateral, posterior malleolus

There could always be more than one bit fractured

Question 15

How are 5th metatarsal base fracture different from adolescent ossification centre of this site?

Answer 15

Fracture of this bone is usually transverse, whereas ossification centre is longitudinal

Question 16

What is usually the cause of tendon rupture?

Answer 16

Can be due to one event but often culmination of various minor tears over the years

Question 17

What are Lisfranc injuries and how do they usually present?