Download - X-Ray Rounds Basics / Wrist Mark Scott Nov. 1, 2007 Basics / Wrist Mark Scott Nov. 1, 2007
X-Ray RoundsX-Ray Rounds
Basics / Wrist
Mark Scott Nov. 1, 2007
Basics / Wrist
Mark Scott Nov. 1, 2007
Systematic ApproachSystematic Approach
Fracture Identification, Look for:• Mal-alignment• Discontinuity• Radio-lucency / radio-opacity• Fat pads
Fracture Identification, Look for:• Mal-alignment• Discontinuity• Radio-lucency / radio-opacity• Fat pads
Mal-AlignmentMal-Alignment
DiscontinuityDiscontinuity
RadiolucencyRadiolucency
Fat PadsFat Pads
Rule of 2’sRule of 2’s
• 2 views• 2 joints• 2 sides (esp. for children)• 2 times (before/after)
• 2 views• 2 joints• 2 sides (esp. for children)• 2 times (before/after)
Fracture DescriptionFracture Description
• Location (bone, level)• Pattern (type of #, open vs. closed)• Alignment (of distal segment)• Angulation• Rotation• Displacement• Salter classification
• Location (bone, level)• Pattern (type of #, open vs. closed)• Alignment (of distal segment)• Angulation• Rotation• Displacement• Salter classification
Transverse # of distal radius with 100 dorsal angulation?
Transverse # of distal radius with 100 dorsal angulation?
Colles FractureColles Fracture
Oblique # of distal radius immediately proximal to physis with 2mm of ulnar
displacement?
Oblique # of distal radius immediately proximal to physis with 2mm of ulnar
displacement?
Salter II #Salter II #
Salter-Harris ClassificationSalter-Harris Classification
S Separation (I)A Above (II)L Low (III)T Transverse (IV)R cRush (V)
S Separation (I)A Above (II)L Low (III)T Transverse (IV)R cRush (V)
Salter-Harris ClassificationSalter-Harris Classification
Salter IV Salter IV
Salter II Salter II
Salter III Salter III
Colles #, 100 dorsal angulation, ? impaction Colles #, 100 dorsal angulation, ? impaction
# Distal radius, dorsal disl. of scaphoid/lunate# Distal radius, dorsal disl. of scaphoid/lunate
FOOSH, pain with axial loading of 1st MCFOOSH, pain with axial loading of 1st MC
FOOSH, pain with axial loading of 1st MCFOOSH, pain with axial loading of 1st MC
52 M demonstrating gymnastics52 M demonstrating gymnastics
FOOSH 6 yo MFOOSH 6 yo M
ReferencesReferences1. McRae, R. Pocketbook of orthopaedics and fractures
[2nd ed.]. Churchill Livingstone Elsevier, 2006.2. Tintnelli, JE. Emergency medicine: a comprehensive
study guide [6th ed]. American College of Emergency Physicians / McGraw-Hill, New York, 2004. Pp. 1674-84.
3. Ritchie JV. Emergency Emerg Med Clin North Am - 01-NOV-1999; 17(4): 823-42
1. McRae, R. Pocketbook of orthopaedics and fractures [2nd ed.]. Churchill Livingstone Elsevier, 2006.
2. Tintnelli, JE. Emergency medicine: a comprehensive study guide [6th ed]. American College of Emergency Physicians / McGraw-Hill, New York, 2004. Pp. 1674-84.
3. Ritchie JV. Emergency Emerg Med Clin North Am - 01-NOV-1999; 17(4): 823-42