Radiological manifestations of common MSK conditions Dr Richard Beese Dr Sheela Anpalakhan Online webinar 18/7/2018

Slipped capital epiphysis of the left hip Slipped upper femoral epiphysis

Perthes Disease Perthes

Osteoarthrosis of the right knee there is total loss of the medial compartment joint space with marginal osteophytes and subchonral sclerosis , the knee joint spaces of the left knee are preserved. Degenerative knee X-ray

The appearances are of OA of right hip There is complete loss of the joint space of the right hip with collapse to the right femoral head The appearances are of OA of right hip Degenerative hip

OA right shoulder, there is loss of joint space of the glenohumeral joint with osteophytes. Degenerative shoulder

How does OA effect the patient ? Pain and loss of function This may result in loss of job if severe enough Huge impact on patients and families. There is a degenerative scoliosis of the lumbar spine Concave to the right, there is loss of disc space at l3/L4 and L2/3

There is an intertrochanteric fracture of the left hip Fall onto left side There is an intertrochanteric fracture of the left hip Shentons line is disrupted 10-15% hip fractures are not seen on xray Why ? Fractures are only visible if displaced, non displaced hip fractures are not visible. If the patient has persistent symptoms C T or MRI is required. Do not miss a non displaced hip fracture ! Hip fracture

Bimalleolar ankle fracture

Left colles fracture, distal radial fracture.

Left femoral fracture , these fractures bleed and the patient may be in shock.

Limping child, toddlers tibial fracture

Neck trauma ; Burst fracture of C4 look at the loss of alignment of the anterior cervical line and spinolaminar line.

Limping child after a cold, there is a hip effusion, there is fluid in the joint with lifting of the capsule, arrow transient synovitis almost certainly a transudate, but an exudate should be suspected in the correct clinical setting.

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