<ul><li>By :DR  </li></ul><ul><li>HASSAN  ALQARNI </li></ul><ul><li>Supervised by </li></ul><ul><li>DR. munawar </li></ul>
How to comment on  Skeleton - X rays
<ul><li>When looking on an X ray of a part of the skeleton, check for: </li></ul><ul><ul><li>Name of patient </li></ul></u...
<ul><ul><li>Is there more than one view (should be two views at right angle) </li></ul></ul><ul><ul><li>Quality of the fil...
<ul><li>How we describe fractures on X ray ? </li></ul>
By the direction of the fracture line   Longitudinal  oblique Transverse  spiral
<ul><li>By the number of fracture fragments </li></ul><ul><li>Two fragments –Simple </li></ul><ul><li>More than two fragme...
<ul><li>By the relationship of the fracture to the atmosphere  </li></ul><ul><ul><li>Closed  </li></ul></ul><ul><ul><li>Op...
<ul><li>By the relationship of one fracture fragment to another  </li></ul><ul><ul><li>Displacement  </li></ul></ul><ul><u...
By convention, abnormalities of position describe the relationship of the distal fragment relative to the proximal fragment
<ul><li>Displacement </li></ul><ul><ul><li>The amount of antero-posterior or lateral movement  of the distal fragment rela...
<ul><li>Angulation </li></ul><ul><ul><li>The abnormal angle that the distal fragment makes with the proximal </li></ul></u...
<ul><li>Shortening </li></ul><ul><ul><li>Overlapping of the ends of the fracture fragments  </li></ul></ul><ul><ul><li>Sho...
<ul><li>Rotation </li></ul><ul><ul><li>Almost always involves long bones (humerus and femur)  </li></ul></ul><ul><ul><li>K...
<ul><li>Colle’s fracture </li></ul><ul><ul><li>Fracture of the distal radius with dorsal angulation </li></ul></ul><ul><ul...
<ul><li>Smith’s fracture  </li></ul><ul><ul><li>fracture of the distal radius with anterior displacement and palmar angula...
Examples of easily missed fractures
scaphoid fracture Buckle  fracture
Supracondylar fracture of the humerus
Posterior dislocation of the shoulder <ul><li>Humeral head looks like “light bulb”  </li></ul><ul><li>Usually need lanothe...
Hip fractures <ul><li>May be very subtle and require bone scan or MRI for diagnosis  </li></ul><ul><li>In this case, white...
<ul><li>Start by commenting on: </li></ul><ul><ul><li>The view: AP or lateral view </li></ul></ul><ul><ul><li>The part exa...
 
-Fractured ribs marked
Monteggia_Fracture
_left Clavicle fracture
X-ray showing the distal portion of a fractured tibia and intramedular nail.
An old fracture with nonunion of the fracture fragments.
 
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نسخ من How to read x ray of the skeleton 2008 2009

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نسخ من How to read x ray of the skeleton 2008 2009

  1. 1. <ul><li>By :DR </li></ul><ul><li>HASSAN ALQARNI </li></ul><ul><li>Supervised by </li></ul><ul><li>DR. munawar </li></ul>
  2. 2. How to comment on Skeleton - X rays
  3. 3. <ul><li>When looking on an X ray of a part of the skeleton, check for: </li></ul><ul><ul><li>Name of patient </li></ul></ul><ul><ul><li>Date of examination </li></ul></ul><ul><ul><li>Side (Rt or Lt): check marker </li></ul></ul><ul><ul><li>What part the film is centered on </li></ul></ul><ul><ul><li>Does the film cover the whole area required </li></ul></ul><ul><ul><ul><li>Include one joint above and one joint below </li></ul></ul></ul>
  4. 4. <ul><ul><li>Is there more than one view (should be two views at right angle) </li></ul></ul><ul><ul><li>Quality of the film (penetration) </li></ul></ul><ul><ul><li>Abnormalities: </li></ul></ul><ul><ul><ul><li>Trace around the bone margins looking for steps or cracks </li></ul></ul></ul><ul><ul><ul><li>Look for soft tissue swelling </li></ul></ul></ul><ul><ul><li>Compare how the appearance changed from last film </li></ul></ul><ul><ul><li>Conclude: </li></ul></ul><ul><ul><ul><li>Is the diagnosis clear </li></ul></ul></ul><ul><ul><ul><li>Is further images needed </li></ul></ul></ul>
  5. 5. <ul><li>How we describe fractures on X ray ? </li></ul>
  6. 6. By the direction of the fracture line Longitudinal oblique Transverse spiral
  7. 7. <ul><li>By the number of fracture fragments </li></ul><ul><li>Two fragments –Simple </li></ul><ul><li>More than two fragments-Comminuted </li></ul>
  8. 8. <ul><li>By the relationship of the fracture to the atmosphere </li></ul><ul><ul><li>Closed </li></ul></ul><ul><ul><li>Open or compound </li></ul></ul><ul><ul><li>Best evaluated clinically </li></ul></ul>
  9. 9. <ul><li>By the relationship of one fracture fragment to another </li></ul><ul><ul><li>Displacement </li></ul></ul><ul><ul><li>Angulation </li></ul></ul><ul><ul><li>Shortening </li></ul></ul><ul><ul><li>Rotation </li></ul></ul><ul><li>Most fractures display more than one of these abnormalities </li></ul>
  10. 10. By convention, abnormalities of position describe the relationship of the distal fragment relative to the proximal fragment
  11. 11. <ul><li>Displacement </li></ul><ul><ul><li>The amount of antero-posterior or lateral movement of the distal fragment relative to the proximal </li></ul></ul><ul><ul><li>There is lateral displacement of the distal fracture fragment (femur) </li></ul></ul>
  12. 12. <ul><li>Angulation </li></ul><ul><ul><li>The abnormal angle that the distal fragment makes with the proximal </li></ul></ul><ul><ul><li>In this case the distal fragment is angulated medially </li></ul></ul>
  13. 13. <ul><li>Shortening </li></ul><ul><ul><li>Overlapping of the ends of the fracture fragments </li></ul></ul><ul><ul><li>Shortening is usually described by the number of centimeters of overlap </li></ul></ul>
  14. 14. <ul><li>Rotation </li></ul><ul><ul><li>Almost always involves long bones (humerus and femur) </li></ul></ul><ul><ul><li>Knee joint is in AP position (points forward) but ankle points lateral, in this case </li></ul></ul>
  15. 15. <ul><li>Colle’s fracture </li></ul><ul><ul><li>Fracture of the distal radius with dorsal angulation </li></ul></ul><ul><ul><li>Caused by a fall on the out stretched hand </li></ul></ul>Common Fracture Eponyms
  16. 16. <ul><li>Smith’s fracture </li></ul><ul><ul><li>fracture of the distal radius with anterior displacement and palmar angulation </li></ul></ul><ul><ul><li>Caused by a fall on a flexed hand </li></ul></ul>
  17. 17. Examples of easily missed fractures
  18. 18. scaphoid fracture Buckle fracture
  19. 19. Supracondylar fracture of the humerus
  20. 20. Posterior dislocation of the shoulder <ul><li>Humeral head looks like “light bulb” </li></ul><ul><li>Usually need lanother view like axillary or Y view </li></ul>
  21. 21. Hip fractures <ul><li>May be very subtle and require bone scan or MRI for diagnosis </li></ul><ul><li>In this case, white zone of sclerosis is an impacted subcapital fracture </li></ul>
  22. 22. <ul><li>Start by commenting on: </li></ul><ul><ul><li>The view: AP or lateral view </li></ul></ul><ul><ul><li>The part examined: femur, tibia and fibula… </li></ul></ul><ul><ul><li>The side: right or left </li></ul></ul><ul><ul><li>The abnormality seen </li></ul></ul><ul><ul><li>Example: this is an AP View of the right femur. There is a transverse or oblique or comminuted fracture of the middle 1/3 or the upper third of the shaft , There is lateral displacement and medical angulation </li></ul></ul><ul><ul><li>If you are provided with one view, you may say that I need another view to complete my comment </li></ul></ul>
  23. 24. -Fractured ribs marked
  24. 25. Monteggia_Fracture
  25. 26. _left Clavicle fracture
  26. 27. X-ray showing the distal portion of a fractured tibia and intramedular nail.
  27. 28. An old fracture with nonunion of the fracture fragments.
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