CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSISEISENBERG

1. 33 Eponyms of Fractures

2. CLINICAL IMAGAGING
AN ATLAS OF DIFFERENTIAL DAIGNOSIS
EISENBERG
DR. Muhammad Bin Zulfiqar
PGR-FCPS III SIMS/SHL

3. • Fig B 33-1 Mallet (baseball) finger. The small
triangular fragment (arrow) is proximally
retracted by the action of the common extensor
tendon. The flexion deformity results from the
unopposed action of the flexor digiti profundus
tendon.

4. • Fig B 33-2 Bennett fracture.

5. • Fig B 33-3 Rolando fracture. In addition to the
fracture of the ulnar margin, similar to that found
in a Bennett fracture, there is a second fragment
at the radial margin, which characterizes this as a
Rolando fracture.39

6. • Fig B 33-4 Gamekeeper thumb with fracture.39

7. • Fig B 33-5 Boxer fracture (arrow).

8. • Fig B 33-6 Colles' fracture. (A) Frontal and (B)
lateral projections show overriding and dorsal
displacement of the distal fragment.

9. • Fig B 33-7 Smith fracture. Lateral view shows
volar angulation of the distal fragment, the
reverse of that encountered in a Colles fracture.39

10. • Fig B 33-8 Chauffeur fracture. Complete
fracture extending diagonally across the base
of the radial styloid.39

11. • Fig B 33-9 Reverse Barton fracture. (A) Fracture of the distal radius
with shortening of the radius and avulsion of the ulnar styloid. The
appearance is similar to a Colles or a Smith fracture in this
projection. (B) Lateral projection shows that the fracture of the
distal radius creates a large fragment from the anterior rim of the
distal radius. The posterior rim is intact. The anterior fragment
includes approximately two-thirds of the joint surface.39

12. • Fig B 33-10 Nightstick fracture. Minimally
displaced oblique fracture of the ulna without
associated fracture of the radius. (L, left.)39

13. • Fig B 33-11 Monteggia fracture. Displaced
fracture of the ulnar shaft associated with
anterior dislocation of the radial head.

14. • Fig B 33-12 Galeazzi fracture. A lateral
projection shows the dorsally angulated distal
radial fracture and the obvious disruption of
the distal radioulnar joint. The ulna is intact.39

15. • Fig B 33-13 Greenstick fracture. Frontal image of a
young child who fell off a bike shows incomplete
fractures of the radius and ulna. The cortex is fully
broken (black arrows) on one side of the bone and
intact on the other side (white arrows).40

16. • Fig B 33-14 Little League elbow. Frontal and lateral views of
the elbow in an active pitcher shows rarefaction and
fragmentation of the capitellum (arrow) from repetitive
overuse of the elbow.40

17. • Fig B 33-15 Hill-Sachs deformity.

18. • Fig B 33-16 Bankhart fracture. Fracture of the anterior rim of the
glenoid (arrow) as a result of anterior dislocation of the shoulder.39

19. • Fig B 33-17 March fracture. Frontal radiographs
of the right foot of a college gymnast show the
early (A) and late (B) findings of a fatigue fracture
of the second metatarsal (arrow). The fracture
completely healed with rest.40

20. • Fig B 33-18 Jones' fracture. Note that the
fracture line is transverse (black arrow),
whereas the normal apophysis in this child has
a vertical orientation (white arrow).

21. • Fig B 33-19 Lisfranc injury. Gross lateral
displacement of the second through fifth
metatarsals.

22. • Fig B 33-20 Chopart dislocation. (A) Lateral and
(B) frontal views. Lateral projection shows
complete disruption of the calcaneocuboid joint.
The cuboid bone is displaced plantarward, while
the talonavicular joint is subluxed.39

23. • Fig B 33-21 Toddler fracture. Frontal radiograph of a young
ambulatory infant, who fell and twisted his right lower leg, shows a
spiral fracture (arrows) in the distal portion of the tibia.40

24. • Fig B 33-22 Maisonneuve fracture. (A) Frontal
and (B) lateral views of the ankle demonstrate
an oblique fracture of the medial malleolus
and a fracture of the posterior tibial tubercle
(arrows). (C) A view of the proximal leg reveals
the associated spiral fracture of the proximal
shaft of the fibula (arrow).41

25. • Fig B 33-23 Jefferson fracture. (A) On a frontal
tomogram, there is lateral displacement of the
lateral masses of C1 bilaterally (white lines).
(B) A CT scan in another patient shows the
unilateral break in the arch of C1 (arrow). (D,
dens.)

26. • Fig B 33-24 Hangman fracture. Bilateral
fracture of the neural arch of C2 (broad
arrow). The abnormal air within the soft
tissues (thin arrows) was due to an associated
fracture of the larynx.

27. • Fig B 33-25 Clay shoveler fracture. (A) Frontal view of
the cervical spine shows the characteristic double-
spinous-process sign resulting from the caudad
displacement of the avulsed fragment (open arrow)
with respect to the normal position of the major
portion of the spinous process (closed arrow). (B) A
lateral view clearly shows the avulsed fragment
(arrow).

28. • Fig B 33-26 Chance fracture. (A) A frontal view shows the
characteristic empty appearance of the involved vertebral
body due to fractures of the posterior elements. Note the
fractures of the left pedicle (black arrow) and transverse
process (white arrows). (B) CT scan in another patient
shows a fracture of the lumbar vertebral body (black
arrows) associated with a lamina fracture at the same level
(white arrow).

29. • Fig B 33-27 Malgaigne fracture. There are fractures of the right
superior and inferior pubic rami (white arrows) and wide separation
of the ipsilateral sacroiliac joint (large black arrows). There is also
some sacroiliac joint separation, an avulsion of the L5 transverse
process on the left, and a fracture of the right pubic symphysis
(small black arrow).

30. • Fig B 33-28 Straddle fracture. Bilateral
fractures (arrows) of the superior and inferior
pubic rami.

31. • Fig B 33-29 LeFort planes of weakness. (A)
Frontal view corresponding to a Caldwell
projection. (B) Lateral view.42