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CT3 MSK Radiology

CT3 MSK Radiology. 1. 1. A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated distal ulna “Opposite injury?” Monteggia. 2. 2.

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CT3 MSK Radiology

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  1. CT3 MSK Radiology

  2. 1

  3. 1 • A 39y.o. goalkeeper falls over playing for the local club. • Name of fracture? Galeazzi • Distinguishing features? # Radius, Dislocated distal ulna • “Opposite injury?” Monteggia

  4. 2

  5. 2 • An 89 yr old lady who has collapsed in the kitchen complaining of a stiff neck. • 1. What is the injury? Type 3 Odontoid peg # • 2. Name 2 systems for clearing neck injuries. NEXUS, Ottawa rules

  6. 3a

  7. 3a. • A 34 yo motorcyclist thrown from his bike at 65mph. • Spot the injury Crush # L4, (subtle wedge # L2) • Is this likely to be stable or unstable? Unstable as 2 columns are disrupted

  8. 3b

  9. 3b The same motorcyclist also has this injury • What is it? True dislocation of knee • What are the two most important management priorities (after ABC and analgesia!) Relocation Imaging of popliteal artery

  10. 4

  11. 4 Another knee injury – this lady fell from a horse • What type of # is this? Tibial plateau # • Give three management principles ABCDE – this is a high impact injury Analgesia – including comfort slab Orthopaedic Referral (imaging and definitive treatment)

  12. 5a

  13. 5a • 57 yr old man falls off a ladder onto hand • Name (or describe) of # Bennett’s fracture • What is the definitive management? Requires operative stabilisation

  14. 5b

  15. 5b He also sustains this injury. • In which other specific area do you look for injury? Spine

  16. 6

  17. 6 • A man falls off his bike straight onto his shoulder • Name the injury A-C joint Dislocation • What is the prognosis? Good • What other potentially life threatening injury might you be able to see? Pneumothorax

  18. 7a 7

  19. 7 It’s Saturday night… • Name the xRay Jug Handle view • What is the fractured bone? Left zygomatic arch

  20. 7b

  21. 7b He also complains of pain in his Right hand • What specific factor must you assess to ensure function? Presence / absence of rotational deformity

  22. 8a

  23. 8 18 month old boy who wakes crying in the night – may have got foot caught in cot sides Well child, not walking on Lt leg • Give 2 differential diagnoses? Toddler’s fracture, Hip pathology, Septic arthritis / osteomyelitis • What is your management? Analgesia, make arrangements for review.

  24. 8b

  25. He is seen again 2 days later. He is mardy and pale. He is not eating and “feels hot” – having regular calpol. What 2 differential diagnoses must you consider? Osteomyelitis Septic Arthritis

  26. 9

  27. 9 A 57 yr old lady falls downstairs and has a swollen foot. • What is the name of injury? Lis-Franc Injury (T-MT # / dislocation) • What other view do you need? True lateral xRay

  28. 10

  29. 10 Another goalkeeper – a 10 yr old playing in goal making a crucial save. He is now complaining of a sore wrist • What is the diagnosis? Torus (buckle) # distal radius • Give two management points? Splint (or PoP) for analgesia and home Do not play football for 4-6 weeks

  30. 11

  31. 11 A 13 y.o. who twisted his ankle and is tender over the base of the 5th Metatarsal • What is the diagnosis? Ligamentous injury

  32. 12

  33. 12 A 27 yr old who fell off a step in a nightclub wearing high heels, and has a swollen ankle. • What is the injury? Fracture base of 5th Metatarsal

  34. 13

  35. 13 A 22 yr old on the 1st day of summer. • What is the likely mechanism? • Give 3 things that this man needs? Analgesia Tetanus / antibiotics Urgent debridement and wound toilet

  36. 14

  37. 14 • Where is the abnormality? Middle phalanx, ring finger • What is the most likely diagnosis? Enchondroma

  38. 15

  39. 15 An 8 month old baby who got her foot trapped under sofa and was unable to free herself. She is refusing to W/B. • What is the injury? Toddler’s fracture (buckle fracture distal tibia)

  40. 16

  41. 16 • What is the injury? Fractured surgical neck of humerus • What other structure is at risk? Axillary nerve • Give 2 definitive ED management strategies Collar & Cuff Hanging U slab

  42. 17

  43. 17 A 67 yr old man who tripped up a kerb • What 3 radiological signs are there? Elevated anterior fat pad Visible posterior fat pad Fracture radial head • Give 2 options for pain relief? Medication Collar & cuff Aspiration of elbow

  44. 18

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