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Imaging
• Plain X-ray
• Arteriogram
• On OR table
• Angiography
• CT Angio
• MRI
• CT scan
• Avulsions ( better detail)
• Associated fractures (distal femur,
proximal tibia)
• CT Angio
Plain X-ray
•Plain x-ray : AP and Lateral
•Abnormal joint space
•Subluxation
•Associated Fractures (prox
tibia, distal femur)
MRI
• Indicated for ALL
multiligamentous injury
• Gives detail of all non-bony
structures
• Menisci
• Articular cartilage
• Ligaments
• Tendons (biceps, Popliteus, ITB)
• MR Angiogram (MRA)
MRI
• Identify ligament injury
• Partial vs. Complete
• Midsubstance vs. Avulsion from
origin/insertion
• Meniscus
• Displaced tear
• Helps Determine Treatment Plan
• Timing (early in ligament avulsions, displaced
meniscus tear)
• Procedure (repair vs. reconstruction)
• Surgical Approach
Vascular Investigations
Access for:
• Color, temperature, Pulses
• ABI (Ankle Brachial Index)
• ≥0.9: Serial examination
• <0.9: further
study/exploration
• ABI is the ratio of the BP in the lower legs to the BP in the arms.
• Compared to the arm, lower BP in the leg is an indication of blocked arteries.
• ABI is calculated by dividing SBP at the ankle by SBP in the arms.
Vascular Examination
•ABI ≥0.9 & no signs of
vascular injury: Arterial
study may not be necessary
if
• Serial examination q 2-4 hrs
for 48 hrs can reliably be
performed
•If not, arterial study may
be ordered to r/o vascular
injury

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4. knee investigations

  • 1. Imaging • Plain X-ray • Arteriogram • On OR table • Angiography • CT Angio • MRI • CT scan • Avulsions ( better detail) • Associated fractures (distal femur, proximal tibia) • CT Angio
  • 2. Plain X-ray •Plain x-ray : AP and Lateral •Abnormal joint space •Subluxation •Associated Fractures (prox tibia, distal femur)
  • 3. MRI • Indicated for ALL multiligamentous injury • Gives detail of all non-bony structures • Menisci • Articular cartilage • Ligaments • Tendons (biceps, Popliteus, ITB) • MR Angiogram (MRA)
  • 4. MRI • Identify ligament injury • Partial vs. Complete • Midsubstance vs. Avulsion from origin/insertion • Meniscus • Displaced tear • Helps Determine Treatment Plan • Timing (early in ligament avulsions, displaced meniscus tear) • Procedure (repair vs. reconstruction) • Surgical Approach
  • 5. Vascular Investigations Access for: • Color, temperature, Pulses • ABI (Ankle Brachial Index) • ≥0.9: Serial examination • <0.9: further study/exploration • ABI is the ratio of the BP in the lower legs to the BP in the arms. • Compared to the arm, lower BP in the leg is an indication of blocked arteries. • ABI is calculated by dividing SBP at the ankle by SBP in the arms.
  • 6. Vascular Examination •ABI ≥0.9 & no signs of vascular injury: Arterial study may not be necessary if • Serial examination q 2-4 hrs for 48 hrs can reliably be performed •If not, arterial study may be ordered to r/o vascular injury