x-ray rounds basics / wrist mark scott nov. 1, 2007 basics / wrist mark scott nov. 1, 2007
TRANSCRIPT
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X-Ray RoundsX-Ray Rounds
Basics / Wrist
Mark Scott Nov. 1, 2007
Basics / Wrist
Mark Scott Nov. 1, 2007
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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
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Mal-AlignmentMal-Alignment
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DiscontinuityDiscontinuity
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RadiolucencyRadiolucency
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Fat PadsFat Pads
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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)
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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
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Transverse # of distal radius with 100 dorsal angulation?
Transverse # of distal radius with 100 dorsal angulation?
Colles FractureColles Fracture
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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 #
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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)
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Salter-Harris ClassificationSalter-Harris Classification
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Salter IV Salter IV
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Salter II Salter II
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Salter III Salter III
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Colles #, 100 dorsal angulation, ? impaction Colles #, 100 dorsal angulation, ? impaction
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# Distal radius, dorsal disl. of scaphoid/lunate# Distal radius, dorsal disl. of scaphoid/lunate
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FOOSH, pain with axial loading of 1st MCFOOSH, pain with axial loading of 1st MC
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FOOSH, pain with axial loading of 1st MCFOOSH, pain with axial loading of 1st MC
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52 M demonstrating gymnastics52 M demonstrating gymnastics
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FOOSH 6 yo MFOOSH 6 yo M
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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