ONLINE LESSON 1: IDENTIFYING RADIAL HEAD FRACTURES By: Dr. Kenneth Fortgang

1. ONLINE LESSON 1: IDENTIFYING RADIAL HEAD FRACTURES By: Dr. Kenneth Fortgang

3. UNIV OF SOUTHERN CAL/LAC; SURGICAL INTERNSHIP

4. USC/LACOUNTY; RADIOLOGY RESIDENCY AND INTERVENTIONAL FELLOWSHIP

5. NORTH BROWARD HOSPITAL DISTRICT; LEVEL I AND LEVEL II TRAUMA CENTERS

6. RADIAL HEAD FRACTURES Kenneth C. Fortgang, MD Medical Director Premier Radiology Services

7. ELBOW ANATOMY

8. X-RAY ANATOMY

9. X-RAY ANATOMY

10. U L N A R A D I U S TROC CAP H U M E R U S Anatomy ©Ken L Schreibman, PhD/MD 2003

11. H U M E R U S U L N A TROC OLECRANON CORONOID Anatomy ©Ken L Schreibman, PhD/MD 2003 R A D I U S CAP

12. Fat Pads H U M E R U S CAP Anterior Fad Pad (Coronoid Fossa) Posterior Fad Pad (Olecranon Fossa) ©Ken L Schreibman, PhD/MD 2003 U L N A R A D I U S

13. NORMAL, NO EFFUSION

14. CAN YOU SEE THE FRACTURE?

15. CAN YOU SEE THE FRACTURE?

17. Alignment

18. Bone Contour

19. Margins

20. Density

21. Tabecular pattern

22. Soft tissues

24. Look for sail sign and posterior fat pad

25. If these signs are present but no fracture is identified, radial head fracture is likely.

26. Look for a fracture line and contour deformity

27. Radiographic Signs of Radial head fracture on Lateral view

29. Type II: angulated or >2 mm displaced

30. Type III: comminuted

31. RADIAL HEAD FRACTURE WITH FAT PADS

32. Anterior and Posterior Fat Pad

33. Figure 1. Lateral radiograph shows a positive fat pad sign in a patient with a nondisplaced fracture of the radial head. Goswami G K Radiology 2002;222:419-420 ©2002 by Radiological Society of North America

35. No FAT PAD

36. FAT PADS

37. SAGITTAL EFFUSION

38. CT FRACTURE AND EFFUSION

39. EFFUSION

41. RADIAL NECK FRACTURE AND MINIMAL EFFUSION

42. RADIAL HEAD FRACTURE WITH EFFUSION

43. MRI EFFUSION TAKE THIS HOME

46. If elbow can’t be extended, obtain AP/lat of both humerus and forearm

47. PREMIER RADIOLOGY SERVICES