Msk trauma
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Msk trauma

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Msk trauma Msk trauma Presentation Transcript

  • MSK Trauma .Prof.Dr.Hesham Kotb .Professor of Radiodiagnosis, Alex. University
  • 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.
  • Radiologically Occult Fractures Imaging Modalities: 1) 2) 3) • • 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)
  • 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
  • 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 capsular structures. • Common sites: • Knee , femur , humerus , elbow ,Ankle & Foot.
  • :Chronic Osseous Trauma • Fatigue fractures –abnormal stress across normal bone. • Insufficiency fractures—normal stress across abnormal bone. - Femoral neck - Sacrum - Supraacetabular - Pubic bones, superior and inferior pubic rami
  • Recognizing Fractures ((And describing them  A disruption in all or part of the cortex of a bone. • All = Complete. • Part = Incomplete.
  • Incomplete Fractures  GreenstickFacture through one cortex  Buckled – Fracture with buckling of the cortex.
  • 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(.
  • Description of Fractures  By direction of fractures line. = Transverse. = Oblique. = Longitudinal. = Spiral
  • Description of Fractures  By the relationship of the fragments. - Displacement. - Shortening. - Angulation. - Rotation.  Most fractures display more than one of these abnormalities of position.
  • Description of Fractures  Number of fragments: 1- Simple: Two fragments. 2- Comminuted : More than two fragments.
  • Description of Fractures  Open Or closed fracture.  Gas lucency at the soft tissue.
  • ??Diagnosis Please
  • Common Fracture Eponyms -Colle's Fracture. -Smith's Fracture. -Jones Fracture. -Boxer's Fracture.
  • Common Fracture Eponyms • Colle's Fracture. Fracture of the distal radius with a dorsal angulation
  • Common Fracture Eponyms • Smith's Fracture. - Fracture of the distal radius with a palmar angulation. - Fall on a flexed hand.
  • Common Fracture Eponyms • Jones Fracture. Fracture base of the fifth metatarsal
  • Common Fracture Eponyms  Boxer's Fracture. Fracture head of the fifth metacarpal with palmar angulation.
  • Fracture Healing 1. Indistinctness of Fracture line. 2. Bony callus formation. 3. Bridging of fracture and obliteration of fracture line. 4. Remodeling of bone.
  • Fracture Healing