Barton Fx
dorsal margin of distal radius best viewed laterally
Reverse Barton Fx
volar margin of the distal radius best viewed laterally
Hutchinson Fx
Radial margin of the distal radius best viewed with PA
Smith Fx
Large fx of the distal radius that displaces volarly
MOI fall on back of hand or direct blow to dorsum of hand
Galeazzi Fx
Fx of distal 1/3 of radius with proximal end displaced dorsally
MOI FOOSH or blow to dorsolateral wrist
Best view of scaphoid bone
PA with ulnar deviation
MOI FOOSH
Best view of pisiform and pisotriquetral joint
Supinated oblique
Best view of triquetral bone and radial styloid
Pronated oblique
Best view of hook of hammate, pisiform, and volar aspect of trapezium
Carpel tunnel view (full wrist extension)
Bennet Fx
Fx of proximal end of the 1st metacarpal
Boxers Fx
Fx of metacarpal neck (typically 5th) with volar angulation of distal fragment
Gamekeepers Thumb
Fx of base of proximal phalanx
Stener Lesion
Ruptured end of ulnar collateral ligament displaced superficially to the adductor pollicis aponeurosis
Hulten Variance (ulnar variance)
radial styloid process normally exceeds the length of articular end of ulna by 9-12 mm
Negative variance ulna is more proximal (more than 12 mm)
Positive variance ulna is displaced distally and has less ulnar variance
Radial angle
ulnar slant 15-25 degrees
Palmar Inclination
Volar tilt of the articular surface of radius 10-25 degrees
TFCC
Triangular Fibrocartilage Complex Triangular fibrocartilage Radioulnar ligament Ulnocarpal ligament Extensor Carpi Ulnaris tendon sheath Meniscus homologue
Normal Elbow carrying angle
approx 15 degrees
CRITOE
Capitellum Radial Head Internal (Medial) Epicondyle Trochlea Olecranon External (Lateral) Epicondyle
If you see only 3 fragments should be the first 3 on the list otherwise (they disappear with External epicondyle first)
Elbow Lateral View
Best view for olecranon process, anterior radial head, humeroradial joint
Disad- poor view of posterior radial head and coronoid process
Radial head Capitellum view
Radial head visible free of coranoid process, good view of capitellum, hueroradial and humeroulnar
What position do most elbow fractures occur in?
extension
Radial head fx Mason System
Type 1 - Undisplaced Type 2 - Displaced Type 3 - Comminuted (multiple fragments) Type 4 - Fx with dislocation MOI FOOSH
Osteochondritis Dissecans
Panner Disease valgus strain of elbow leads to fllattening of capitellum
Radial head articulates with what part of the humerus?
Capitellum
Ulnar coronoid process articulates with what part of the humerus?
Trochlea
Monteggia Fx
Fx of ulna and dislocation of radius
MOI: force pronating during fall or direct blow to posterior ulna
Bado Classification
Type 1 Distal Ulna displaced posteriorly
Type 2 Distal Ulna displaced anteriorly
Type 3 Distal ulna displaced laterally
Type IV Proximal fx of both radius and ulna
Grashey View
Patient Rotated 40 toward side of suspected injury
Used to visualize glenoid in profile
Axillary view
Shot from above with patient in abduction
Identifies A/P dislocation
West point view
Patient lies prone in abduction, radiograph angled at 25 degrees to patients midline and 25 degrees to table surface
Best for anterior inferior rim of glenoid
Lawrence View
Patient supine with arm abducted
Demonstrates A/P view
Transthoracic Lateral View
Valuable for determining degree of displacement or angulation of bony fragment of proximal humerus
Bicipital View
pt leans forward with hand in supination
Used to visualize trauma to bicipital groove
AC View
patient is erect with arm in neutral, beam is directed upward 15 degrees
Acromial Morphology
Type 1 Flat
Type 2 Smoothly curved
Type 3 Hooked
Transcapular (Y) View
pt is erect, rotated 20 degrees, beam directed at medial border of protruding scapula
Demonstrates scapular fx
Most common position of ant shoulder dislocation
ABD, EXT, ER
Diagnosed with AP and Y scapular view
Bankart Fx
Inferior glenoid fossa fx
Hills-Sach Lesion
Posterolateral Humeral head lesion from impact with anterior inferior glenoid fossa during anterior dislocation
Posterior Shoulder Dislocation
Rare (2-3% of shoulder dislocations)
Position Add, Flx, IR
Caused by direct force or electric shock/siezure
Post-traumatic Osteolysis
Reabsorption of distal acromial end of clavicle eventually resulting in marked widening of the AC Joint
Ligaments involved in AC joint separation
Acromioclavicular ligament
Coracoclavicular ligament
Signs of Chronic Cuff Tear
Eroded inferior aspect of acromion
Narrowed Acromiohumeral joint space
Flattening of the greater tuberosity
A
Alignment
Size of bone, number of bones, shape and contour of bone, bone and joint position
Shades of Gray Darkest to Brightest (6)
Air (black) –> Fat (gray/black)–> Water (Gray) –> Bone (white) –> Contrast media (bright white) –> Heavy metals (solid white)
B
Bone Density
C
Cartilage Space
Width and symmetry
S
Soft Tissue
Swelling, Fat pad displacement
Ulnar ring thing is associated with what joint
triquetrohamate
Sites of Ulnar nerve entrapmet
Cubital tunnel, tunnel of guyon, flexor carpi ulnaris
