X-Ray Rounds Basics / Wrist Mark Scott Nov. 1, 2007 Basics / Wrist Mark Scott Nov. 1, 2007.

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Presentation transcript:

X-Ray Rounds Basics / Wrist Mark Scott Nov. 1, 2007 Basics / Wrist Mark Scott Nov. 1, 2007

Systematic Approach Fracture Identification, Look for: Mal-alignment Discontinuity Radio-lucency / radio-opacity Fat pads Fracture Identification, Look for: Mal-alignment Discontinuity Radio-lucency / radio-opacity Fat pads

Mal-Alignment

Discontinuity

Radiolucency

Fat Pads

Rule of 2s 2 views 2 joints 2 sides (esp. for children) 2 times (before/after) 2 views 2 joints 2 sides (esp. for children) 2 times (before/after)

Fracture Description Location (bone, level) Pattern (type of #, open vs. closed) Alignment (of distal segment) Angulation Rotation Displacement Salter classification Location (bone, level) Pattern (type of #, open vs. closed) Alignment (of distal segment) Angulation Rotation Displacement Salter classification

Transverse # of distal radius with 10 0 dorsal angulation? Colles Fracture

Oblique # of distal radius immediately proximal to physis with 2mm of ulnar displacement? Salter II #

Salter-Harris Classification SSeparation (I) AAbove (II) LLow (III) TTransverse (IV) RcRush (V) SSeparation (I) AAbove (II) LLow (III) TTransverse (IV) RcRush (V)

Salter-Harris Classification

Salter IV

Salter II

Salter III

Colles #, 10 0 dorsal angulation, ? impaction

# Distal radius, dorsal disl. of scaphoid/lunate

FOOSH, pain with axial loading of 1st MC

52 M demonstrating gymnastics

FOOSH 6 yo M

References 1.McRae, R. Pocketbook of orthopaedics and fractures [2nd ed.]. Churchill Livingstone Elsevier, Tintnelli, JE. Emergency medicine: a comprehensive study guide [6th ed]. American College of Emergency Physicians / McGraw-Hill, New York, Pp Ritchie JV. Emergency Emerg Med Clin North Am - 01-NOV- 1999; 17(4): McRae, R. Pocketbook of orthopaedics and fractures [2nd ed.]. Churchill Livingstone Elsevier, Tintnelli, JE. Emergency medicine: a comprehensive study guide [6th ed]. American College of Emergency Physicians / McGraw-Hill, New York, Pp Ritchie JV. Emergency Emerg Med Clin North Am - 01-NOV- 1999; 17(4):