Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Introduction skeletal radiology(11月20.)

16,836 views

Published on

  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (Unlimited) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/qURD } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/qURD } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download doc Ebook here { https://soo.gd/qURD } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://bit.ly/2m77EgH } ......................................................................................................................... Download Full EPUB Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... Download Full doc Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... Download PDF EBOOK here { http://bit.ly/2m77EgH } ......................................................................................................................... Download EPUB Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... Download doc Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THAT BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { http://bit.ly/2m77EgH } ......................................................................................................................... Download Full EPUB Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... Download Full doc Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... Download PDF EBOOK here { http://bit.ly/2m77EgH } ......................................................................................................................... Download EPUB Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... Download doc Ebook here { http://bit.ly/2m77EgH } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book that can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer that is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story That Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths that Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Are you literally FEEDING your diabetes putting this one "health" food on your dinner plate? This is important. You must stop eating this food today or you could be doubling the speed at which your diabetes progresses... ♥♥♥ https://bit.ly/2n5cFHd
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Introduction skeletal radiology(11月20.)

  1. 1. MUSCULOSKELETAL RADIOLOGY Sun Yat-sen Memorial Hospital SYSU Dr. BILING LIANG
  2. 2. Musculoskeletal Radiology <ul><li>INTRODUCTION </li></ul><ul><ul><li>IMAGING TECHNOLOGY </li></ul></ul><ul><ul><li>NORMAL APPEARANCE </li></ul></ul><ul><ul><li>BASIC X-RAY SIGN </li></ul></ul><ul><ul><li>RADIOLOGY DIAGNOSIS OF COMMON DISEASES </li></ul></ul>
  3. 3. Imaging technology <ul><li>X-ray : plain film </li></ul><ul><ul><li>Very good X-ray density resolution in bone & joint , the resolution of soft tissue not enough </li></ul></ul><ul><li>CT : as X-ray, but good for positioning </li></ul><ul><li>MR : </li></ul><ul><ul><li>advantage : very good soft tissue resolution </li></ul></ul><ul><ul><li>disadvantage : not sensitivity to display calcification </li></ul></ul><ul><li>US : </li></ul><ul><ul><li>Non-invasive image method, easy to perform </li></ul></ul><ul><ul><li>Can evaluate the soft tissue abnormalities </li></ul></ul>
  4. 4. <ul><li>Skeletal CT </li></ul><ul><ul><li>Soft tissue window : </li></ul></ul><ul><ul><ul><li>Bone </li></ul></ul></ul><ul><ul><ul><li>muscle </li></ul></ul></ul><ul><ul><li>Bone window: </li></ul></ul><ul><ul><ul><li>Cortical : </li></ul></ul></ul><ul><ul><ul><li>Trabecula : network </li></ul></ul></ul><ul><ul><ul><li>Bone marrow cavity : </li></ul></ul></ul><ul><ul><ul><li>low density </li></ul></ul></ul>
  5. 5. X-ray plain film & arthrogram
  6. 6. Normal X-ray appearances <ul><li>Bone – structure & development </li></ul><ul><li>Joint </li></ul><ul><li>Spine </li></ul><ul><li>Soft tissue </li></ul>
  7. 7. Normal X-ray appearances <ul><li>Bone structure & development </li></ul><ul><ul><li>Structure : </li></ul></ul><ul><ul><ul><li>Cortical bone (compact ) </li></ul></ul></ul><ul><ul><ul><li>Cancellous bone (Trabecula ) </li></ul></ul></ul><ul><ul><li>Development : </li></ul></ul><ul><ul><ul><li>intramembranous ossification </li></ul></ul></ul><ul><ul><ul><li>Endochondral ossification </li></ul></ul></ul>Same histologic structure Different arrangement Cartilage -> bone formation -> remodel -> trabecular bone
  8. 8. Normal X-ray appearances cortex trabecula
  9. 9. Normal pediatric X-ray appearances 4 years , distal femur metaphysis epiphysis Epiphyseal plate
  10. 10. Normal pediatric X-ray appearances 9 m , distal femur 增殖带 成熟带 肥大带 退变带 成骨带 静止细胞带 {
  11. 11. Normal pediatric skeletal development 6M 1Y 2Y 3Y 4Y
  12. 12. Normal adult X-ray appearances Diaphysis shaft
  13. 13. Normal pediatric X-ray appearances <ul><li>The ossification centers & the secondary ossification display & fusion, will occur at certain time of the life, refer to as bone age </li></ul>Bone age yrs ±1 New born
  14. 14. Normal X-ray appearances <ul><li>The types of skeleton: </li></ul><ul><ul><li>Long bone </li></ul></ul><ul><ul><ul><li>Pediatric : diaphysis 、 metaphysis 、 epiphysis 、 epiphyseal plate </li></ul></ul></ul><ul><ul><ul><li>Adult : diaphysis (shaft) 、 </li></ul></ul></ul><ul><ul><li>Short bone </li></ul></ul><ul><ul><li>Flat bone – hematopoiesis </li></ul></ul><ul><ul><li>Irregular bone </li></ul></ul><ul><li>Joint </li></ul>
  15. 15. <ul><li>Short bone </li></ul>Normal appearances pediatric adult
  16. 16. <ul><li>Flat bone </li></ul>Normal appearances
  17. 17. <ul><li>Spine </li></ul>Normal appearances
  18. 18. Normal X-ray appearances <ul><li>Bone </li></ul><ul><li>Joint -- structure </li></ul><ul><li>Spine </li></ul><ul><li>Soft tissue </li></ul>
  19. 19. Normal X-ray appearances <ul><li>Joint </li></ul><ul><ul><li>Synovial joint -- knee </li></ul></ul><ul><ul><li>Fibrous joint -- </li></ul></ul><ul><ul><li>Cartilaginous joint -- SI </li></ul></ul><ul><ul><li>Synostosis joint – skull </li></ul></ul>
  20. 20. <ul><li>Joint is an organ </li></ul><ul><ul><li>Articular capsule </li></ul></ul><ul><ul><li>synovium </li></ul></ul><ul><ul><li>cartilage </li></ul></ul><ul><ul><li>Cortical bone </li></ul></ul><ul><ul><li>Ligament & tenden </li></ul></ul><ul><ul><li>Fluid </li></ul></ul><ul><li>Joint space </li></ul><ul><ul><li>cartilage </li></ul></ul>Articular cartilage Epiphyseal cartilage Fibrocartilage dics X-ray
  21. 22. Normal hip <ul><ul><li>bony articular surface </li></ul></ul><ul><ul><li>joint space </li></ul></ul>
  22. 23. Normal joint structure <ul><li>Elbow -- Synovial joint </li></ul><ul><li>SI joint -- Cartilaginous joint </li></ul>
  23. 24. <ul><li>wrist </li></ul>Normal joint structure
  24. 25. Basic X-ray signs <ul><li>Osteoporosis </li></ul><ul><li>Osteomalacia </li></ul><ul><li>Bone destruction </li></ul><ul><li>Osteosclerosis </li></ul><ul><li>Periosteal reaction </li></ul><ul><ul><li>Calcification </li></ul></ul><ul><ul><li>Bone necrosis </li></ul></ul><ul><ul><li>Mineral sedimentation </li></ul></ul><ul><ul><li>Bone deformity </li></ul></ul><ul><ul><li>Soft tissue abnormalities </li></ul></ul>Musculoskeletal system Bone Joint <ul><li>Joint swellen </li></ul><ul><li>Joint dislocation </li></ul><ul><ul><li>Joint destruction </li></ul></ul><ul><ul><li>Joint bony/fibrous ankylosis </li></ul></ul>
  25. 26. Osteoporosis <ul><li>Definition : </li></ul><ul><ul><li>The bone matrix or osteoid specific deficiency </li></ul></ul><ul><ul><li>Both of the organic material & calcium are decreased, but the ratio of them still normal </li></ul></ul><ul><li>X-ray appearance : </li></ul><ul><ul><li>Bone density decreased, local / general </li></ul></ul><ul><ul><li>The cortex become thinner , the trabeculae become thin and decreased number </li></ul></ul><ul><ul><li>Pathological fracture </li></ul></ul><ul><li>Etiology : </li></ul><ul><ul><li>Common : elderly , immobilization </li></ul></ul><ul><ul><li>Path : hormonal / vitamine deficiency </li></ul></ul>Basic X-ray signs
  26. 27. <ul><li>Spine oteoporosis </li></ul><ul><ul><li>Vertibral body deformity as “ fish vertibral ” </li></ul></ul><ul><ul><li>Bone density decreased </li></ul></ul><ul><ul><li>Trabecula thinner </li></ul></ul>Osteoporosis Basic X-ray signs normal c
  27. 28. <ul><li>Thallassaemia </li></ul><ul><ul><li>Chronic haemolytic anaemias cause widening of the spongiosa / cortex thinning in the proximal ends of long bone </li></ul></ul>Osteoporosis Basic X-ray signs
  28. 29. Osteomalacia <ul><li>Definition : </li></ul><ul><ul><li>Insufficient mineralization of the osteiod </li></ul></ul><ul><ul><li>Lack of calcium for bone formation </li></ul></ul><ul><li>X-ray appearance : </li></ul><ul><ul><li>Bone density decreased generally, bone become softened and bend or even break, vertebral bodies biconcave (fish vertebrae) </li></ul></ul><ul><ul><li>The cortex become thinner, “ ground glass ” change, deficient bone formation </li></ul></ul><ul><ul><li>Pseudo-fracture, Pathological fracture </li></ul></ul><ul><li>Etiology : </li></ul><ul><ul><li>Deficient Vitamine D, Calcium (inadequate intake) </li></ul></ul><ul><ul><li>Excessive loss of calcium in renal disease </li></ul></ul>Basic X-ray signs
  29. 30. <ul><li>Rickets </li></ul><ul><ul><li>Bone density decreased </li></ul></ul><ul><ul><li>Bone softening & bend </li></ul></ul><ul><ul><li>Metaphysis </li></ul></ul><ul><ul><li>splaying & the epiphyseal plate widening </li></ul></ul>Osteomalasia Basic X-ray signs
  30. 31. <ul><li>Rickets </li></ul><ul><ul><li>Bone density decreased </li></ul></ul><ul><ul><li>Bone softening & bowed </li></ul></ul>Osteomalasia Basic X-ray signs
  31. 32. Bone destruction Basic X-ray signs <ul><li>Definition : </li></ul><ul><ul><li>The pathologic tissue replaced the normal bone structure (cortex or spongiosa) </li></ul></ul><ul><li>X-ray appearance : </li></ul><ul><ul><li>Bone density decreased, rarefaction of bone </li></ul></ul><ul><ul><li>The cortex erosion </li></ul></ul><ul><li>Etiology : </li></ul><ul><ul><li>Inflammation or granuloma </li></ul></ul><ul><ul><li>Tumor or tumor-like lesion </li></ul></ul>
  32. 33. <ul><li>Simple bone cyst : </li></ul><ul><ul><li>Massive bone destruction / radiolucency area in proximal femur with well-defined margin, the cortex become thinning </li></ul></ul>Bone destruction Basic X-ray signs
  33. 34. <ul><li>Giant cell tumor </li></ul><ul><ul><li>Eccentric expanding (cystic) translucency area in the proximal fibilar bone , with multi-locular appearance </li></ul></ul>Bone destruction Basic X-ray signs
  34. 35. <ul><li>Giant cell tumor </li></ul><ul><ul><li>Eccentric expanding (cystic) translucency area in the distal radial bone </li></ul></ul>Bone destruction Basic X-ray signs
  35. 36. <ul><li>Tuberculosis of right hip </li></ul><ul><ul><li>Moth-eaten pattern bone destruction in cortex & trabeculae </li></ul></ul><ul><ul><li>Joint space narrowing </li></ul></ul>Bone destruction Basic X-ray signs
  36. 37. Osteosclerosis /hyperostosis Basic X-ray signs <ul><li>Definition : </li></ul><ul><ul><li>Increase of amount of bone matrix in given volume of bone </li></ul></ul><ul><li>X-ray appearance : </li></ul><ul><ul><li>Bone density increased </li></ul></ul><ul><ul><ul><li>Cortex thicken – periosteal growing </li></ul></ul></ul><ul><ul><ul><li>Bone marrow cavity narrowing – endostosis growing and trabecular thickening </li></ul></ul></ul><ul><li>Etiology : </li></ul><ul><ul><li>Inflammation or granuloma (chronic) </li></ul></ul><ul><ul><li>Trauma & fracture </li></ul></ul><ul><ul><li>Tumor or tumor-like lesion </li></ul></ul>
  37. 38. <ul><li>Chronic osteomyelitis : </li></ul><ul><ul><li>Med-low part of the tibia </li></ul></ul><ul><ul><li>Cortex thickening </li></ul></ul><ul><ul><li>Bone marrow cavity narrowing and obliteraed </li></ul></ul>Osteosclerosis Basic X-ray signs
  38. 39. <ul><li>Chronic osteomyelitis </li></ul><ul><ul><li>Osteosclerosis of the bone between the areas of destruction </li></ul></ul><ul><ul><li>Bone marrow cavity narrowing & obliteration </li></ul></ul>Osteosclerosis Basic X-ray signs
  39. 40. <ul><li>Osteosarcoma </li></ul><ul><ul><li>Osteosclerosis inside the lesion </li></ul></ul>Osteosclerosis Basic X-ray signs
  40. 41. <ul><li>Osteosarcorma </li></ul><ul><ul><li>Osteosclerosis inside the lesion </li></ul></ul><ul><ul><li>Periosteal reaction </li></ul></ul>Osteosclerosis Basic X-ray signs
  41. 42. <ul><li>Spinal metestasis </li></ul><ul><ul><li>T11 verteble body bone density increased </li></ul></ul>Osteosclerosis Basic X-ray signs
  42. 43. <ul><li>骨质斑驳症 </li></ul>Osteosclerosis Basic X-ray signs <ul><li>Osteopetrosis </li></ul>
  43. 44. Periosteal reaction / periostosis Basic X-ray signs <ul><li>Definition : </li></ul><ul><ul><li>Periosteal new bone formation cause by various condition stimulated </li></ul></ul><ul><li>X-ray appearance : </li></ul><ul><ul><li>The newly developed periosteal bone in different form: </li></ul></ul><ul><ul><li>lamellae (onion peel) , spicules (sunrays) , lacelike , spurs , et al. </li></ul></ul><ul><li>Etiology : </li></ul><ul><ul><li>Inflammation or granuloma (chronic) </li></ul></ul><ul><ul><li>Trauma & fracture </li></ul></ul><ul><ul><li>Tumor or tumor-like lesion </li></ul></ul>Codman ’ s triangle: The new periosteal bone become eroded centrally leaving triangle areas of New bone at the edges
  44. 45. <ul><li>Subacute osteomyelitis </li></ul><ul><ul><li>Smoth lamellae Periosteal reaction </li></ul></ul>Periosteal reaction / periostosis Basic X-ray signs normal
  45. 46. <ul><li>Lacelike & spicules periosteal reaction </li></ul>Periosteal reaction / periostosis Basic X-ray signs
  46. 47. <ul><li>Fracture unhealing </li></ul><ul><ul><li>Massive periosteal reaction surrounding the ulnar fracture area </li></ul></ul>Periosteal reaction / periostosis Basic X-ray signs
  47. 48. <ul><li>Osteosarcoma </li></ul><ul><ul><li>lamellae & spicules periosteal reaction, formed Codman ’ s triangle </li></ul></ul>Periosteal reaction / periostosis Basic X-ray signs
  48. 49. <ul><li>periosteal reaction destructed by tumor </li></ul><ul><li>Formed Cordmen ’ s triangle </li></ul>Periosteal reaction / periostosis Basic X-ray signs
  49. 50. Calcification within bone/cartilage Basic X-ray signs <ul><li>X-ray appearance : </li></ul><ul><ul><li>The high X-ray density spot inside bone /soft tissue /mass </li></ul></ul><ul><li>Etiology : </li></ul><ul><ul><li>Inflammation or granuloma or degeneration , or bone necrosis (chronic) </li></ul></ul><ul><ul><ul><li>Irregular shape </li></ul></ul></ul><ul><ul><li>Cartilage tumor </li></ul></ul><ul><ul><ul><li>Ring shape / half-ring shape </li></ul></ul></ul>
  50. 51. <ul><li>chondrosarcoma </li></ul><ul><ul><li>The cartilage calcification (ring-shape) inside the tumor </li></ul></ul>Calcification with bone/cartilage Basic X-ray signs
  51. 52. chondrosarcoma
  52. 53. <ul><li>Calcification after hematoma </li></ul><ul><ul><li>Left shoulder surrounded by massive irregular high density shadow </li></ul></ul>Calcification with bone/cartilage Basic X-ray signs
  53. 54. Bone necrosis Basic X-ray signs <ul><li>Definition : </li></ul><ul><ul><li>The death of bone tissue caused by gradual vascular impairment </li></ul></ul><ul><ul><li>ceasation of metabolism of local bone tissue </li></ul></ul><ul><li>X-ray appearance : </li></ul><ul><ul><li>Sequestrum – fragment of dense/necrotic bone be separated , the X-ray density “ high ” (sequestrum is normal density , cause by the surrounding bone osteoporosis) </li></ul></ul><ul><li>Etiology : </li></ul><ul><ul><li>Inflammation or granuloma (chronic) </li></ul></ul><ul><ul><li>Trauma & fracture </li></ul></ul>
  54. 55. <ul><li>Femoral capital epiphysis </li></ul><ul><ul><li>Slightly increased density of the epiphysis </li></ul></ul><ul><ul><li>The epiphysis becomed fragment and flattened </li></ul></ul><ul><ul><li>Osteoporosis of the neighbouring part of the femur </li></ul></ul>Bone necrosis Basic X-ray signs
  55. 56. <ul><li>Chronic osteomyelitis </li></ul><ul><ul><li>Osteosclerosis of the bone between the areas of destruction </li></ul></ul><ul><ul><li>The separated “ high ” density fragments against the surrounding osteo-translucency zone </li></ul></ul><ul><ul><li>Sequestra – lost blood supply and then the calcium content remain intact </li></ul></ul>Bone necrosis Basic X-ray signs
  56. 57. Mineral sedimentation Basic X-ray signs <ul><li>X-ray appearance : </li></ul><ul><ul><li>Mineral material , (lead , phosphorus , et al.) excessive sedimentation in bone </li></ul></ul><ul><ul><ul><li>Dense bands at metaphyseal end </li></ul></ul></ul><ul><ul><li>High concentrations of fluorine compounds </li></ul></ul><ul><ul><ul><li>Stimulates endosteal & periosteal osteoblastic activity and bone formation </li></ul></ul></ul>
  57. 58. <ul><li>Skeletal fluorosis </li></ul><ul><ul><li>The lumbar spine and pelvis increased bone density </li></ul></ul>Mineral sedimentation Basic X-ray signs
  58. 59. Deformity of bone Basic X-ray signs <ul><li>May be localized or generalized </li></ul>
  59. 60. <ul><li>Multiple exostoses </li></ul>Deformity of bone Basic X-ray signs <ul><li>Enlongated finger </li></ul>
  60. 61. Soft tissue abnormalities Basic X-ray signs <ul><li>May cause by trauma / tumor </li></ul><ul><li>/ infection …… </li></ul>
  61. 63. Basic X-ray signs <ul><li>Osteoporosis </li></ul><ul><li>Osteomalacia </li></ul><ul><li>Bone destruction </li></ul><ul><li>Osteosclerosis </li></ul><ul><li>Periosteal reaction </li></ul><ul><ul><li>Calcification </li></ul></ul><ul><ul><li>Bone necrosis </li></ul></ul><ul><ul><li>Mineral sedimentation </li></ul></ul><ul><ul><li>Bone deformity </li></ul></ul><ul><ul><li>Soft tissue abnormalities </li></ul></ul>Musculoskeletal system Bone Joint <ul><li>Joint swellen </li></ul><ul><li>Joint dislocation </li></ul><ul><li>Joint degeneration </li></ul><ul><ul><li>Joint destruction </li></ul></ul><ul><ul><li>Joint bony/fibrous ankylosis </li></ul></ul>
  62. 64. Joint destruction <ul><li>Cartilage destruction – joint space narrowing </li></ul><ul><li>Cortex destruction – bone destruction & impairment, may cause subluxation / deformity </li></ul>
  63. 65. Joint ankylosis <ul><li>Joint bony / fibrous ankylosis </li></ul>
  64. 66. Joint dislocation The displacement of the any body part from its normal position
  65. 68. MUSCULOSKELETAL RADIOLOGY TRAUMA Sun Yat-sen Memorial Hospital SYSU Dr. BILING LIANG
  66. 69. <ul><li>Fracture : complete or inconplete break in the continuity of bone or cartilage , this requires a loading force applied to bone </li></ul><ul><ul><li>Traumatic fracture </li></ul></ul><ul><ul><li>Stress fracture </li></ul></ul><ul><ul><li>Pathologic fracture </li></ul></ul><ul><li>May acompany severe soft tissue torn / bleeding / important organ torn </li></ul>Fracture & dislocation Trauma
  67. 70. <ul><li>Purpose of Radiology </li></ul><ul><ul><li>Evaluated fracture / dislocation </li></ul></ul><ul><ul><ul><li>position </li></ul></ul></ul><ul><ul><ul><li>Apposition </li></ul></ul></ul><ul><ul><ul><ul><li>Anatomical apposition </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Displacement </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Lack of apposition </li></ul></ul></ul></ul><ul><ul><ul><li>Alignmemt </li></ul></ul></ul><ul><ul><ul><li>Rotation </li></ul></ul></ul><ul><ul><li>The result of reduction </li></ul></ul><ul><ul><li>Healing of fracture & callus formation </li></ul></ul><ul><ul><ul><li>Un-union & delayed union </li></ul></ul></ul><ul><ul><ul><li>Infection </li></ul></ul></ul><ul><ul><ul><li>Ossificatory myositis </li></ul></ul></ul><ul><li>Imagine technique </li></ul><ul><ul><li>X-ray </li></ul></ul><ul><ul><li>CT </li></ul></ul><ul><ul><li>MRI </li></ul></ul><ul><ul><li>US </li></ul></ul><ul><ul><li>SCINTIGRAPHY </li></ul></ul>fracture & dislocation Trauma The state of contact of the fracture fracgment ends The relationship of the long axes of the fracture fragments
  68. 71. <ul><li>X-ray : </li></ul><ul><ul><li>Fracture line : the break of bone shows a irregular translucent line (separated – translucent </li></ul></ul><ul><ul><li>overlap - dense) </li></ul></ul><ul><ul><ul><li>Transverse fracture / oblique fracture / spiral fracture </li></ul></ul></ul><ul><ul><ul><li>Compression / crush fracture </li></ul></ul></ul><ul><ul><ul><li>Comminution fracture ( > 2) / segmental fracture </li></ul></ul></ul><ul><ul><li>Incomplete fracture : </li></ul></ul><ul><ul><li>Fracture in children </li></ul></ul><ul><ul><ul><li>Greenstick fracture : </li></ul></ul></ul><ul><ul><ul><li>Epiphyseal separation </li></ul></ul></ul>fracture & dislocation Trauma
  69. 72. <ul><li>The fracture types </li></ul>Fracture & dislocation Trauma spiral fracture Transverse fracture Compressive fracture Comminution fracture oblique fracture
  70. 73. <ul><li>The distal third of the tibia & fibula Comminution fracture </li></ul>Fracture & dislocation Trauma
  71. 74. <ul><li>X-ray : </li></ul><ul><ul><li>Fracture line : the break of bone shows a irregular translucent line </li></ul></ul><ul><ul><ul><li>Transverse fracture / oblique fracture / spiral fracture </li></ul></ul></ul><ul><ul><ul><li>Comprese fracture </li></ul></ul></ul><ul><ul><ul><li>Comminution fracture ( > 2) / segmental fracture </li></ul></ul></ul><ul><ul><li>Incomplete fracture : </li></ul></ul><ul><ul><li>Fracture in children </li></ul></ul><ul><ul><ul><li>Greenstick fracture : </li></ul></ul></ul><ul><ul><ul><li>Epiphyseal separation </li></ul></ul></ul>fracture & dislocation Trauma angling or buckling of the cortex without the lucent fracture line Epiphysis & cartilage plate separated from the metaphysis
  72. 75. <ul><li>Linear fracture of the skull </li></ul>Fracture & dislocation Trauma
  73. 76. Healing of fracture & callus formation Acute phase 2W 2M
  74. 77. <ul><li>Lower humerus fracture – deformity of union </li></ul>Fracture & dislocation Trauma
  75. 78. <ul><li>Middle tibia & fibela fracture – deformity of union </li></ul>Fracture & dislocation Trauma Apposition Alignmemt
  76. 79. <ul><ul><ul><li>Un-union & delayed union </li></ul></ul></ul>Fracture & dislocation Trauma
  77. 80. <ul><li>Hip dislocation </li></ul>Fracture & dislocation Trauma <ul><li>Elbow dislocation </li></ul>
  78. 81. <ul><li>Colles ’ fracture </li></ul><ul><ul><li>A transverse fracture through the distal radius </li></ul></ul><ul><ul><li>With dorsal displacement & angulation of the distal radial fragment </li></ul></ul><ul><ul><li>Malalignment as “ silver fork ” deformity </li></ul></ul><ul><ul><li>The ulnar styloid is often detached </li></ul></ul>Fracture & dislocation Trauma
  79. 82. <ul><li>Epicondylar fracture of humerus </li></ul><ul><ul><li>A transverse fracture above the condyles of the humerus </li></ul></ul>Fracture & dislocation Trauma
  80. 83. <ul><li>Epicondylar fracture of humerus </li></ul><ul><ul><li>A transverse fracture above the condyles of the humerus </li></ul></ul>Fracture & dislocation Trauma
  81. 84. <ul><li>Compression / wedge fracture </li></ul>Fracture & dislocation Trauma
  82. 85. <ul><li>Compression / wedge fracture </li></ul>Fracture & dislocation Trauma
  83. 87. <ul><li>Normal intervertebral disc </li></ul>Protrusion of the intervertebral disc (discal herniation) Annulus fibrosis Nucleus pulposus
  84. 88. Protrusion of the intervertebral disc (discal herniation) <ul><li>Normal intervertebral disc </li></ul>Annulus fibrosis Nucleus pulposus Vertebral end plate Stablilize the spine
  85. 89. <ul><li>CT : normal intervertebral disc </li></ul>Protrusion of the intervertebral disc (discal herniation)
  86. 90. Protrusion of the intervertebral disc (discal herniation) bulge protrusion
  87. 91. <ul><li>disc herniation </li></ul>Protrusion of the intervertebral disc (discal herniation) Space occupying lesion
  88. 92. Disc herniation MRI normal
  89. 93. <ul><li>Schmorl ’ s nodule </li></ul>Protrusion of the intervertebral disc (discal herniation) Annulus fibrosis Nucleus pulposus protruded into the end plate – form the Schmorl ’ s nodule
  90. 94. Thank you

×