1. MSK Trauma
.Professor of Radiodiagnosis, Alex. University
2. Osseous Trauma
1) Acute Osseous Trauma:
1- Complete Fractures.
2- Incomplete Fractures
3- Radiologically Occult Fractures:
a) Bone contusions
b) Avulsion Fractures.
2) Chronic Osseous Trauma:
a) Insufficiency Fractures.
b) Fatigue Fractures.
3. Radiologically Occult Fractures
Conventional Radiography: Mostly negative in many acute
and chronic osseous injuries ( Occult injuries)‫ز‬
Radioisotope Scanning :
It has Limitations
- Can be falsely negative foe 24-72 hours after injury.
- Positive scan is non-specific.
- Examination requires 4-6 hours , so delay diagnosis.
MRI: is highly sensitive. A normal MRI excludes the presence
of an osseous injury.
Linear low signal T1 with low signal edema.
High signal (edema) T2 with linear low signal (fracture line)
4. Acute Osseous Trauma
A) Impaction Injuries:
1- Contusion: bone contusion or bruises.
STIR or fat Sat T2 == focal areas of
increased signal- easily missed on non-fat
Sat spin echo T2 as edema and
surrounding fat display similar intensities.
• Sites: ACL tear –Patellar Dislocation
5. Acute Osseous Trauma
• 2- Avulsion Injuries: Occur when excessive
tensile forces result in a piece of bone or cartilage being
pulled away from the host bone by ligament , tendon or
• Common sites:
• Knee , femur , humerus , elbow ,Ankle & Foot.
6. :Chronic Osseous Trauma
• Fatigue fractures –abnormal stress
across normal bone.
• Insufficiency fractures—normal stress
across abnormal bone.
- Femoral neck
- Pubic bones, superior and inferior
7. Recognizing Fractures
((And describing them
 A disruption in all
or part of the
cortex of a bone.
• All = Complete.
• Part =
8. Incomplete Fractures
 GreenstickFacture through one
 Buckled – Fracture
with buckling of the
9. Description of Fractures
By direction of fractures line.
By the relationship of the fragments.
By the number of the fragments.
By communication with the atmosphere.
Age of fracture (recent-healing- healed (
Type of union ( normally alignedmalaligned(.
10. Description of Fractures
 By direction of fractures line.
11. Description of Fractures
 By the relationship of the fragments.
 Most fractures display more than one of
these abnormalities of position.
12. Description of Fractures
 Number of fragments:
1- Simple: Two fragments.
2- Comminuted : More than two
13. Description of Fractures
 Open Or closed
 Gas lucency at the