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Kf georgia prs pp rad head2 (2)

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  • 1.  MEDICAL COLLEGE OF GEORGIA; MD UNIV OF SOUTHERN CAL/LAC; SURGICAL INTERNSHIP USC/LACOUNTY; RADIOLOGY RESIDENCY AND INTERVENTIONAL FELLOWSHIP NORTH BROWARD HOSPITAL DISTRICT; LEVEL I AND LEVEL II TRAUMA CENTERS
  • 2. Kenneth C. Fortgang, MD Medical DirectorPremier Radiology Services
  • 3. Anatomy H U M E R U S TROC CAP U R L A N D A I U S©Ken L Schreibman, PhD/MD 2003
  • 4. Anatomy H U OLECRANON M E R U S TROCCAP R U A L D N I A U S CORONOID©Ken L Schreibman, PhD/MD 2003
  • 5. HPosterior Fad Pad Anterior Fad Pad(Olecranon Fossa) U (Coronoid Fossa) M E R U S CAP ©Ken L Schreibman, PhD/MD 2003
  • 6.  Adequate Exposure Alignment Bone Contour Margins Density Tabecular pattern Soft tissues
  • 7.  Ask for 3 views: AP, oblique extended, lateral 90 degree flexion. Look for sail sign and posterior fat pad If these signs are present but no fracture is identified, radial head fracture is likely. Look for a fracture line and contour deformity
  • 8. Radial head fracture types•Type I: less than 2 mm displacement•Type II: angulated or >2 mm displaced•Type III: comminuted
  • 9. Figure 1. Lateral radiograph shows a positive fat pad sign in a patient with a nondisplaced fracture of the radial head. Goswami G K Radiology 2002;222:419-420©2002 by Radiological Society of North America
  • 10.  Radial neck fracture  Extra-capsular  No FAT PAD
  • 11.  Look for fat pads signs (capsular effusion)  Anterior fat pad (from coronoid fossa) may be normal; compare to other side  Posterior fat pad (from olecranon fossa) is always abnormal Compare to x-rays of other side in children If elbow can’t be extended, obtain AP/lat of both humerus and forearm