good

2.  Radiological investigations are an essential component in the
evaluation and management of traumatic injuries. These
investigations provide valuable information to help identify and
diagnose injuries that may not be immediately apparent on clinical
examination.
 The following are some of the key reasons why radiological
investigations are important in trauma:
 Identify hidden injuries: Radiological investigations such as X-rays,
CT scans, and MRI can help identify injuries that are not visible on
physical examination, such as fractures, dislocations, or internal
organ damage.

3.  Determine the extent of injury: Radiological
investigations can help determine the extent of an
injury, which can assist in determining the
appropriate treatment plan. For example, a CT scan
can help identify the severity of a head injury, which
can guide decisions about the need for surgery or
other interventions.
 Monitor treatment progress: Radiological
investigations can be used to monitor the
effectiveness of treatment and to identify any new
or worsening injuries.
 Guide procedures: Radiological investigations can
also guide procedures such as joint aspiration,
biopsies, and drain insertions.

4.  Radiology plays a crucial role in evaluating and diagnosing trauma cases.
It provides valuable information about the extent of injuries, helps guide
treatment decisions, and assists in monitoring patient progress. Here are
some common modalities of radiology used in trauma cases:
 X-ray: X-rays are often the initial imaging modality used in trauma cases.
They are quick and readily available, making them suitable for assessing
fractures, dislocations, and identifying the presence of foreign bodies. X-
rays are commonly performed on the chest, spine, pelvis, and extremities.
 Ultrasound: Ultrasound is a real-time imaging modality that is often used in
trauma cases for its ability to quickly evaluate specific regions of the body.
It is commonly used to assess abdominal injuries, such as the presence of
fluid or solid organ injuries. Ultrasound is also helpful for evaluating
vascular injuries and detecting the presence of blood clots.

5.  Computed Tomography (CT): CT scans are widely utilized in
trauma cases due to their ability to provide detailed cross-sectional
images of the body. CT scans are particularly useful for evaluating
head injuries, spinal injuries, chest injuries, abdominal injuries, and
pelvic fractures. They can detect injuries to organs, blood vessels,
and bones.
 Magnetic Resonance Imaging (MRI): While MRI is not typically
used as a first-line imaging modality in acute trauma situations, it
can be valuable for evaluating specific injuries or complications.
MRI provides detailed images of soft tissues, making it useful for
assessing spinal cord injuries, ligamentous injuries, joint injuries,
and soft tissue injuries.
 Angiography: Angiography involves the injection of a contrast dye
into blood vessels to visualize their structure and identify any
abnormalities. It is frequently used in trauma cases to evaluate
vascular injuries, such as arterial bleeding or vascular dissection.
Angiography can help guide interventional radiology procedures or
surgical interventions.

6.  X-rays are commonly used in trauma cases to
assess and diagnose various types of injuries.
 Here are some key points about the use of X-rays
in trauma cases:
1. Fracture detection
2. Dislocation identification
3.Joint evaluation
4. Alignment assessment
5. Evaluation of bone stability
6. Foreign body detection

7. COLLES
FRACTURE
The key X-ray findings associated with a
Colles fracture are:
1.Distal Radius Fracture
2 .Dorsal Angulation (fractured end tilts
upward or towards the back of the hand)
3. Radial Shortening (slight decrease in the
overall length of the radius)
4. Articular Incongruity (irregularity or gap in
the joint space)
5. Soft Tissue Changes (swelling or
hematoma formation)

8. HANGMAN’S
FRACTURE
 The Hangman's fracture, also known as
traumatic spondylolisthesis of the axis, is
a specific type of cervical spine fracture
 Fracture of the pars interarticularis of the
C2 vertebra (axis)
 Bilateral or unilateral fracture of the
pedicles of C2
 Forward displacement of C2 (vertebral
body or odontoid process) relative to C3
 Loss of alignment between C2 and C3
vertebrae (spondylolisthesis)

9. FRACTURE OF NECK OF
FEMUR
 The fracture of the neck of the femur, also
known as a hip fracture, is a common injury in
the elderly population. Here are the key X-ray
findings associated with a fracture of the neck of
the femur :
 Disruption of the continuity of the neck of the
femur
 Abnormal angulation or displacement of the
fracture fragments
 Loss of trabecular bone pattern: The normal
trabecular pattern seen in the neck of the femur
may be disrupted or distorted due to the
fracture.
 Varus or valgus deformity: Depending on the
direction of displacement, the fracture may result
in the proximal femur angling inward (varus) or
outward (valgus) in relation to the shaft of the
femur.

10.  BOXER’S FRACTURE
 The key X-ray findings associated
with a Boxer's fracture, which is a
fracture of the metacarpal bone in the
hand:
 Fracture of the fifth metacarpal bone
(commonly referred to as the "pinky"
or little finger metacarpal)
 Transverse or oblique fracture line
across the metacarpal bone
 Angulation or apex dorsal angulation:
The distal fragment of the metacarpal
bone is displaced toward the back of
the hand.
 Cortical disruption: The fracture
line disrupts the smooth contour
of the metacarpal bone's cortical
surface.

11.  The findings of rib fractures
on X-ray may include:
 Discontinuity or breaks in
the normal contour of the
ribs.
 Visible fractures lines or
sharp angles in the ribs.
 Misalignment or
displacement of fractured
rib segments.
 Callus formation, which is
the healing response
characterized by new bone
growth at the fracture site.

12.  Free air: Presence of free air
under the diaphragm can indicate
a perforation of the
gastrointestinal tract, such as a
ruptured stomach or bowel. It
appears as a dark area on X-ray
images.
 Abnormal gas patterns: Unusual
gas patterns in the abdomen,
such as air-fluid levels or
abnormal distribution of gas, may
suggest injury or perforation of
the intestines or other abdominal
organs.

13.  FAST(Focused Assessment with Sonography
for Trauma) is specifically performed in trauma
patients as a focused ultrasound examination to
assess for the presence of free fluid in the
abdomen and chest, which can be indicative of
internal bleeding. It differs from a normal
ultrasound (USG) in terms of its purpose,
speed, and focused approach.


14.  FAST is particularly useful
in the initial assessment of
trauma patients and can
detect the presence of
blood (hemoperitoneum) or
other fluids. FAST can
quickly identify potentially
life-threatening injuries
such as liver or splenic
lacerations, intra-
abdominal bleeding, or free
fluid in the pelvis.

15.  CT scans (Computed Tomography scans) are
widely used in trauma cases due to their ability to
provide detailed cross-sectional images of the
body.
 Here's how CT scans are utilized in trauma cases:
 Rapid and comprehensive imaging
 Detection of internal injuries
 Fracture evaluation
 Evaluation of spinal injuries
 Evaluation of chest and abdominal injuries
 Visualization of traumatic brain injuries

16.  CT (Computed Tomography) scans are versatile imaging
techniques that can be used to examine various parts of
the body. Here are some different types of CT scans
commonly performed:
 Head CT (Cranial CT)
 Chest CT (Thoracic CT)
 Abdominal CT
 Pelvic CT
 Spine CT
 Sinus CT
 Extremity CT

17.  CT scans play a crucial role in the evaluation of
head injuries. They are often the imaging modality
of choice for assessing traumatic brain injuries
(TBIs). Here's how CT scans are utilized in the
context of head injury:
 Detection of skull fractures
 Evaluation of intracranial hemorrhage
 Assessment of brain contusions
 Evaluation of brain swelling and edema
 Identification of other traumatic brain abnormalities

18. CT scan findings observed in
head injuries:
 Skull fractures: CT scans can
identify different types of skull
fractures, such as linear
fractures (simple cracks in the
skull), depressed fractures
(fragments of bone are pushed
inward), and basilar fractures
(fractures at the base of the
skull).
 This is an image of brain
showing bone window which
shows fracture in squamous
temporal bone.

19.  Epidural hematoma:
An epidural hematoma is
a collection of blood
between the skull and the
outer covering of the
brain (dura). On a CT
scan, it appears as a
lens-shaped or biconvex
hematoma with a
characteristic convex
margin and compression
of the underlying brain
tissue.

20.  Subdural hematoma:
Subdural hematoma refers to
bleeding between the brain and
its outer covering (dura). On a
CT scan, it typically appears as a
crescent-shaped or concave
hematoma with varying degrees
of thickness and midline shift.
Acute subdural hematomas may
appear hyperdense, while
chronic subdural hematomas
may appear hypodense.

21.  Subarachnoid
hemorrhage:
Subarachnoid
hemorrhage involves
bleeding into the
space between the
brain and its
membranes
(arachnoid). On a CT
scan, it is
characterized by
diffuse or localized
areas of high density,
often seen around the
brain sulci or within
the cisterns.

22.  Brain contusions:
CT scans can reveal brain
contusions, which are
areas of bruised or
damaged brain tissue.
Contusions may appear as
regions of increased
density or focal swelling
within the brain
parenchyma.

23.  Some common radiological investigations used in thoracic trauma:
 Chest X-ray: Chest X-ray is typically the initial imaging modality used in
evaluating thoracic trauma. It provides a quick assessment of the bony
structures, lungs, and mediastinum. Chest X-rays can help identify
fractures, lung contusions, pneumothorax (collapsed lung), hemothorax
(blood in the chest cavity), pleural effusion (abnormal fluid accumulation in
the pleural space), and mediastinal widening.
 Computed Tomography (CT) Scan: CT scan provides detailed cross-
sectional images of the thoracic region and is more sensitive in detecting
various thoracic injuries. It is particularly useful in evaluating complex
fractures, assessing the extent of pulmonary contusions, identifying
vascular injuries, and detecting injuries to the mediastinum. CT
angiography can be performed to evaluate for vascular injuries and identify
sources of bleeding.

24.  When evaluating pneumothorax, which is
the presence of air in the pleural space
causing lung collapse, several
radiological investigations can be used to
confirm the diagnosis and assess the
extent of the condition.
 Chest X-ray: Chest X-ray is often the
initial imaging modality used to diagnose
pneumothorax. It can reveal
characteristic findings such as the
absence of lung markings at the
periphery of the lung, a visible pleural line
(the visceral and parietal pleura
separated by air), and lung collapse.
Chest X-rays can help determine the size
and location of the pneumothorax and
can also identify associated
complications such as tension
pneumothorax or pneumomediastinum.

25.  Computed Tomography (CT)
Scan:
CT scan is a more sensitive
imaging modality and can
provide detailed information
about the presence and extent
of a pneumothorax. It can
accurately determine the size
and location of the
pneumothorax and can also help
identify associated injuries or
underlying lung pathology. CT
scans are particularly useful in
cases where the diagnosis is
uncertain based on the chest X-
ray findings or when additional
information is needed for
treatment planning

26.  Hemothorax is the accumulation of
blood in the pleural space. It can result
from trauma to the chest, causing injury
to blood vessels, lung tissue, or the
heart. Hemothorax can lead to
decreased lung function and may
require drainage.
 Chest X-ray: Chest X-ray is often the
initial imaging modality used to evaluate
hemothorax. It can reveal findings such
as blunting of the costophrenic angle
(where the diaphragm meets the
ribcage), opacification of the affected
hemithorax, and displacement or
compression of the lung tissue. Chest
X-rays can help determine the presence
of hemothorax and assess the
approximate amount of blood
accumulation.

27.  Computed Tomography (CT)
Scan: CT scan provides detailed
cross-sectional images of the
chest and is more sensitive in
detecting hemothorax compared
to a chest X-ray. CT scans can
accurately assess the location,
extent, and underlying causes of
hemothorax. They can also help
identify associated injuries, such
as rib fractures or organ
damage. CT angiography may
be considered if there is concern
for active bleeding or vascular
injury

28.  CECT stands for Contrast-Enhanced Computed
Tomography. CECT abdomen refers to a specific
imaging study that involves performing a
computed tomography (CT) scan of the
abdomen with the use of a contrast agent to
enhance the visibility of certain structures and
pathology.
 During a CECT abdomen, a contrast agent,
usually iodine-based, is administered either
orally or intravenously to highlight blood vessels,
organs, and other structures in the abdomen.
 CECT abdomen is commonly performed in
cases of abdominal trauma to assess for any
internal injuries, such as organ lacerations,
hematomas, or the presence of free fluid or gas.
It helps guide surgical interventions or other
management decisions.

29.  MRI is typically not done
in trauma cases but in
case of Diffuse Axonal
Injury (DAI) of the brain
which is not detected by
CT scan, MRI helps in
evaluation of such cases.