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EMERGENCY RADIOGRAPHY

EMERGENCY RADIOGRAPHY

Basic principles

  • Images produced by differences in the attenuation coefficients of tissues.
  • 2 orthogonal views required for accurate diagnosis.
  • Use > 2 views in locations where fractures are exceptionally difficult to spot.

Primary signs of a fracture

  1. Cortical disruption.
  2. Lucency through the fracture line.
  3. Impaction sclerosis in weight-bearing bones.

Secondary signs of a fracture

  1. Lipohaemarthrosis: fat-fluid level.
  2. Haemarthrosis: elevation of the fat pad.
  3. Soft tissue swelling.

Describing a fracture

  1. Direction: transverse, oblique, spiral, comminuted.
  2. Location: proximal, mid, distal.
  3. Assess for intraarticular extension.
  4. Displacement: describe the distal fragment relative to its normal anatomical position. E.g. dorsal displacement of a Colle’s fracture, volar displacement of a Smith’s fracture.
  5. Angulation.
  6. Rotation.

Algorithm

  1. Alignment.
  2. Bones.
  3. Soft tissue.

Brain

SOME RADIOLOGICAL PATHOLOGY

Skull

Cervical Spine

Thoracolumbar Spine

Shoulder

Elbow

Forearm

Hand & Wrist

Abdomen

Pelvis

Hip & Proximal femur

Knee

Ankle

Midfoot & Forefoot


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REFERENCES

1. Goodman, L. and Felson, B. (2015). Felson's principles of chest roentgenology. 3rd ed. Philadelphia, PA: Elsevier, Saunders.
2. Dähnert W. Radiology Review Manual. LWW. (2011) ISBN:1609139437. Read it at Google Books - Find it at Amazon
3. Elizabeth Puddy, Catherine Hill; Interpretation of the chest radiograph, Continuing Education in Anaesthesia Critical Care & Pain, Volume 7, Issue 3, 1 June 2007, Pages 71–75, https://doi.org/10.1093/bjaceaccp/mkm014

Ⓒ A. Manickam 2018

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