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GÃY XƯƠNG SƯỜN, SỤN SƯỜN
BS Lê Văn Tài
Trung Tâm Y Khoa MEDIC
• A bone fracture is a medical condition in
which there is a damage in the continuity of
the bone.
• A bone fracture can be the result of high force
impact or stress, or a minimal trauma injury as
a result of certain medical conditions that
weaken the bones, such as osteoporosis,
bone cancer, or osteogenesis imperfecta,
where the fracture is then properly termed a
pathologic fracture.
• High-resolution sonography was performed with a 5-12–
MHz linear array sonography unit.
• The high-resolution sonography of the ribs and costal
cartilage in the most painful area was performed with the
transducer aligned transversely (i.e., parallel to the long
axis of the rib).
• The patients were then turned to a lateral decubitus
position. Thereafter, the entire length of each rib in the
affected area and above and below the rib was scanned
from the costosternal to the costovertebral junction.
• The high-resolution sonograms were reviewed for the
presence of representative findings: cortical disruption
(focal interruption of the echogenic cortical line), callus
formation (echogenic dump with posterior shadow),
cortical deformity (changed shape of echogenic cortical
line such as angulation or stepping.
GẢY XƯƠNG SƯỜN
43-year-old man with trauma 10 days
previously and confirmed traumatic
rib fracture. Radiograph shows
cortical disruption with soft-tissue
swelling (arrows).
43-year-old man with trauma 10 days
previously and confirmed traumatic
rib fracture. Sonogram shows cortical
disruption (arrow) and hematoma
formation (arrowheads) on
transverse and longitudinal scans.
GÃY SỤN SƯỜN
• Costal cartilage fractures are fractures of the
cartilage connecting the ribs anteriorly to the
sternum.
• There is little published data on costal cartilage
fractures. Most reported cases are in males and
resulted from blunt trauma or a fall.
• In young children a costal cartilage fracture can
present as a chest wall mass associated with
pain (differentials include neoplasm and post-
traumatic haematoma). In older patients pain is
the primary complaint.
• Costal cartilages can fracture due to blunt
trauma sustained in high-energy trauma or a
fall. While the more immobile first and second
ribs seem to be more prone to costochondral
separation, the lower ribs can suffer costal
cartilage fracturing more easily.
• Disruptions or fractures of costal cartilage
might result in an unstable rib cage and may
expose thoracic contents, such as the heart,
to injury.
• Plain film: Fractures of the costal
cartilage are challenging to establish on
physical examination and not visible on
plain radiographs, unless there is severe
calcification of the cartilage. Due to their
low incidence they may also be easily
overlooked on additional imaging.
• CT: CT is a reliable method of identifying
costal cartilage fractures. They tend to be
mid-substance (i.e. in the centre of the
costal cartilage) and CT offers the
advantage of demonstrating other injuries,
such as rib fractures and involvement of
lung parenchyma.
• Ultrasound: Ultrasound can be used reliably to
diagnose costal cartilage fractures and can
increase the sensitivity of their detection when
used together with CT scanning Unlike CT it
does not involve radiation and is therefore
preferable in a paediatric population and for
follow-up examinations. Furthermore, it may be
helpful to perform an ultrasound examination
when there is a high clinical suspicion, with or
without a mass, and other modalities have not
demonstrated an injury.
• Signs of a cartilage fracture include a fracture
line, disruption of the anterior echogenic margin,
a step-off deformity or gas located at the
costochondral junction.
• MRI: MRI can demonstrate costal cartilage
fractures as well and, like ultrasound, doesn't
result in radiation exposure.
• Treatment and prognosis: It is unclear if
costal cartilage fractures actually completely
heal, but reported cases state a return to
normal and sports activities when the pain
goes away.
SIêu âm xương sườn, sụn sườn, Bs Tài

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GS Clarisse - 01. CT va MRI so nao - Phuong phap doc va ly giai ket qua
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21. Sieu am doppler trong chan doan va theo doi thai cham phat trien trong tu...
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20. Sieu am doppler san khoa, GS Michel Collet
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19. Sieu am day ron, GS Michel Collet
19. Sieu am day ron, GS Michel Collet19. Sieu am day ron, GS Michel Collet
19. Sieu am day ron, GS Michel Collet
 
18. Sieu am nuoc oi, GS Michel Collet
18. Sieu am nuoc oi, GS Michel Collet18. Sieu am nuoc oi, GS Michel Collet
18. Sieu am nuoc oi, GS Michel Collet
 
17. Sieu am banh nhau, GS Michel Collet
17. Sieu am banh nhau, GS Michel Collet17. Sieu am banh nhau, GS Michel Collet
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16. Sieu am khao sat cuc dau cua thai, GS Michel Collet
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16. Sieu am khao sat cuc dau cua thai, GS Michel Collet
 
15. Sieu am vung co benh ly, GS Michel Collet
15. Sieu am vung co benh ly, GS Michel Collet15. Sieu am vung co benh ly, GS Michel Collet
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14. Sieu am vung co binh thuong, GS Michel Collet
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13. Sieu am loan san sun xuong, GS Michel Collet
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SIêu âm xương sườn, sụn sườn, Bs Tài

  • 1. GÃY XƯƠNG SƯỜN, SỤN SƯỜN BS Lê Văn Tài Trung Tâm Y Khoa MEDIC
  • 2. • A bone fracture is a medical condition in which there is a damage in the continuity of the bone. • A bone fracture can be the result of high force impact or stress, or a minimal trauma injury as a result of certain medical conditions that weaken the bones, such as osteoporosis, bone cancer, or osteogenesis imperfecta, where the fracture is then properly termed a pathologic fracture.
  • 3. • High-resolution sonography was performed with a 5-12– MHz linear array sonography unit. • The high-resolution sonography of the ribs and costal cartilage in the most painful area was performed with the transducer aligned transversely (i.e., parallel to the long axis of the rib). • The patients were then turned to a lateral decubitus position. Thereafter, the entire length of each rib in the affected area and above and below the rib was scanned from the costosternal to the costovertebral junction. • The high-resolution sonograms were reviewed for the presence of representative findings: cortical disruption (focal interruption of the echogenic cortical line), callus formation (echogenic dump with posterior shadow), cortical deformity (changed shape of echogenic cortical line such as angulation or stepping. GẢY XƯƠNG SƯỜN
  • 4. 43-year-old man with trauma 10 days previously and confirmed traumatic rib fracture. Radiograph shows cortical disruption with soft-tissue swelling (arrows). 43-year-old man with trauma 10 days previously and confirmed traumatic rib fracture. Sonogram shows cortical disruption (arrow) and hematoma formation (arrowheads) on transverse and longitudinal scans.
  • 5. GÃY SỤN SƯỜN • Costal cartilage fractures are fractures of the cartilage connecting the ribs anteriorly to the sternum. • There is little published data on costal cartilage fractures. Most reported cases are in males and resulted from blunt trauma or a fall. • In young children a costal cartilage fracture can present as a chest wall mass associated with pain (differentials include neoplasm and post- traumatic haematoma). In older patients pain is the primary complaint.
  • 6. • Costal cartilages can fracture due to blunt trauma sustained in high-energy trauma or a fall. While the more immobile first and second ribs seem to be more prone to costochondral separation, the lower ribs can suffer costal cartilage fracturing more easily. • Disruptions or fractures of costal cartilage might result in an unstable rib cage and may expose thoracic contents, such as the heart, to injury.
  • 7. • Plain film: Fractures of the costal cartilage are challenging to establish on physical examination and not visible on plain radiographs, unless there is severe calcification of the cartilage. Due to their low incidence they may also be easily overlooked on additional imaging.
  • 8. • CT: CT is a reliable method of identifying costal cartilage fractures. They tend to be mid-substance (i.e. in the centre of the costal cartilage) and CT offers the advantage of demonstrating other injuries, such as rib fractures and involvement of lung parenchyma.
  • 9. • Ultrasound: Ultrasound can be used reliably to diagnose costal cartilage fractures and can increase the sensitivity of their detection when used together with CT scanning Unlike CT it does not involve radiation and is therefore preferable in a paediatric population and for follow-up examinations. Furthermore, it may be helpful to perform an ultrasound examination when there is a high clinical suspicion, with or without a mass, and other modalities have not demonstrated an injury. • Signs of a cartilage fracture include a fracture line, disruption of the anterior echogenic margin, a step-off deformity or gas located at the costochondral junction.
  • 10. • MRI: MRI can demonstrate costal cartilage fractures as well and, like ultrasound, doesn't result in radiation exposure. • Treatment and prognosis: It is unclear if costal cartilage fractures actually completely heal, but reported cases state a return to normal and sports activities when the pain goes away.