prelegere osteoarticular en

7/24/2019 Prelegere Osteoarticular En

1/93


2/93

OSTEO-ARTICULAR SYSTEM

Bony structure

Gross section

photographic image of

proximal part of the

femur

X-ray image of thesame gross section


3/93


Distribution of lines offorce in the region of

femoral neck


4/93


5/93

Defnition:


6/93


7/93


8/93

Classifcation o racture:

Complete

By mechanism;

By number

By direction of fractures line

Incomplete

By mechanism;


9/93


10/93

Types o racture: bymechanism

Force fracture

Stress fracture

Direct fracture Indirect fracture

Gunshot fracture

Pathological fracture


11/93

Gunshot racture


12/93


13/93

Uncommonfractures

Stress and pathologic

etiologies

Presentationmaterialforeducationalpurposesonly.Allrightsreserved.1999URMCRadiology. 13/30


14/93


15/93

Types o racture: bynumber:

Uniue

!ultiple

Communited Concurrent


16/93

Unique (simple) racture


17/93

Multiple racture = morethan one line o racture


18/93


19/93


20/93

Concurrentracture

omp ete racture


21/93

omp ete ractureTypes o racture: by

irection

OSTEO ARTIC!AR S"STE#


22/93

OSTEO-ARTIC!AR S"STE#

Symptom of fracture $ line of fracture

a% Trans&ersal ' (% T-shape( )% O)lic ' e% *-shape( c% !ongitu(inal


23/93


24/93


25/93


26/93


27/93


28/93


29/93


30/93


31/93


32/93


33/93


34/93

!ma"in" semiolo"y oractures:

Fractures tra"ectory

Displacement of fractured fragments



35/93

OSTEO ARTIC!AR S"STE#

Symptom of fracture $ (isplacement of fragments

a% !ateral ' (% !ongitu(inal )y

)% !ongitu(inal )y interloc+ing sli(ing ' e% Angular

c% !ongitu(inal ,ith ' f% Rotation

elongate( extremity


36/93

#racture $% &s CT


37/93

Manible #racture

!andible fractures are due to direct trauma# !ost are comminuted

and typically in$ol$e both sides of the mandible


38/93

'pine #ractures

%bliue fracture of a lo&er cer$ical

spinous process'

commonly C(#

It results from hyperfle)ion' commonly from

sho$eling sno


39/93

Compression #racture

Compression fractures of the spine are

common in elderly and osteoporotic

patients# *hey result from anterior or

lateral fle)ion# *he typical appearance

is loss of height of the anterior aspect

of the $ertebral body &ith preser$ation

of the posterior elements and generally

the posterior aspect of the $ertebral body#

#


40/93

*umerus

Pathologic fractures result from an

underlying abnormality of the bone'

usually either from a primary bone

tumor or from metastatic disease#

+o&e$er' pathologic fractures may

result from metabolic conditions as&ell# , pathologic fracture results

&hen normal stress is placed onto

abnormal bone#


41/93

Greenstic+ #racture

*he greenstic- fracture results from

direct trauma# *here is an incomplete

fracture of a long bone .radius or ulna/

&ith cortical disruption on one side and

deformity on the other' resulting in

bo&ing of the bone#


42/93

,o%er-s #racture

So named because of the common

occurrence in pri0efighters' the

fracture in$ol$es the distal

metacarpal nec-' usually of digit

fi$e# *he distal fracture fragment

is $olarly angulated and may be

e)ternally rotated# *he in"ury

results from direct trauma to the

hand#



43/93

Radiograph of the femur

Shortening of the bone

by sliding of thefragments


44/93

I i i l f l ti


45/93

Imaging semiology of luxation(dislocation


46/93


47/93


48/93


49/93

Posterior

elbo&

Dislocations


50/93



51/93

Radiograph of the

elbow

Changes in correlationof articular surfaces

(displacement


52/93


53/93


54/93

!maging diagnosis of osteoarticular


55/93

pathology

1

Changes in shape an( (imensions% Bone atrophy . hypertrophy

/% Bone inflation

0% Bone (eformation1 Changes of structure

% Osteoporosis/% Osteosclerosis

0% 1estruction

2% Osteonecrosis

3% Osteolysis1 Changes in periosteum

% 4eriostosis

/% periostitis1 Changes in soft tissues

C!anges in s!a"e and dimensions


56/93

g "

"ony deformity

#rched $ #ngular $ S%shaped



57/93

"one atrophy &ccentric $ Concentric



58/93

Radiograph of the leg "one atrophy by

compression



59/93

'%ray of the femur

"lown bone (bone

inflation

Changes of the contours


60/93

'%ray of thefemur

hickening of thebone

(hyperostosis=hypertrophya) *niform

b) *nilateral

Changes of the contours


Ch f t t


61/93

+steoporosis

,ormal

Spongiose bone

Compact bone

Changes of structure



62/93

'%ray of lumbar part of spine



63/93

'%ray of the knee

-ypertrophic

osteoporosis

An+ilosis



64/93

+steosclerosis

,ormal

Spongiose bone

Compact bone

' f h l + l i



65/93

'%ray of the leg) +steosclerosis)

.ocal sclerosis $ Diffuse sclerosis



66/93

'%ray of the femur

+steodestruction in

osteomyelitis



67/93

'%ray of the foot

+steodestruction in tuberculosis osteitis



68/93

'%ray of the leg

+steodestruction in

osteogenic sarcoma



69/93

'%ray of the leg

+steodestruction in

metastasis



70/93

'%ray of the arm

+steodestruction in

solitary bony cyst



71/93

'%ray of the forearm +steodestruction in giant

cell tumor of the bone



72/93

'%ray of the leg +steodestruction in giant

cell tumor of the bone



73/93

'%ray of the foot fingers

+steolysis of the falangs



74/93

'%ray of the elbow

+steolysis of the articular

ends



75/93

'%ray of the knee

Spongiose seuestrum



76/93

'%ray of the femur

Cortical seuestrum

f



77/93

ocaliation of seuestrum !ntraosseous $ 2enetretion $ &traosseous

(in ca4ity

Ch i ft ti


78/93

Changes in soft tissues

The options are many such as:

Gas in the soft tissues - a sign of an open

fracture or gas gangrene

calcification of various nature

Increase and decrease volume

The presence of foreign bodies

Calcification of various nature


79/93

Gas in the soft tissues


80/93

Increase and decrease

volume

The presence of foreign bodies



81/93

'%ray of the femur

!ntraosseous localiation

of the seuestrum



82/93

'%ray of the leg

inear periostosis



83/93

'%ray of the femur

Stratified periostosis



84/93

'%ray of the femur

.ringe%shaped periostosis



85/93

'%ray of the femur

Ruche%shaped periostosis



86/93

'%ray of the leg

#cicular periostosis

' f th k

Articular changes


87/93

'%ray of the knee

hinning of the radiological articular space *niform $ ,on%uniform


'%ray of the pel4is


88/93

'%ray of the pel4is

hickening of the radiological articular space onright in osteochondropathy



89/93

hickening of the

radiological articular

space by destruction ofarticular ends)



90/93

'%ray of the knee

Subchondral plate

sclerosis



91/93

'%ray of the shoulder

+steophytosis



92/93

'%ray of the

coofemoral 5oint

#rthrosis deformans



93/93

Radiograph of the

elbow

Changes in correlationof articular surfaces

(displacement

prelegere osteoarticular en

Documents