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RADIOLOGY OFRADIOLOGY OFBONESBONES

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RADIOLOGY OF BONESRADIOLOGY OF BONES

BONEBONETRAUMATRAUMA

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BONES:BONES:

Bone is specialized form of connectiveBone is specialized form of connectivetissue.tissue.

Extra cellular components areExtra cellular components aremineralized.mineralized.

This confers marked rigidity & strength.This confers marked rigidity & strength.

While retains some degree of elasticity.While retains some degree of elasticity.

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GENERAL STRUCTURE OFGENERAL STRUCTURE OF

LONG BONES.LONG BONES.

Epiphysis.Epiphysis.

Physis or Epiphyseal plate.Physis or Epiphyseal plate.

Metaphysis.Metaphysis.

Diaphysis.Diaphysis.

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RADIOLOGY OF BONESRADIOLOGY OF BONES

Bone is Radio opaque & appearsBone is Radio opaque & appearswhite on X-rays.white on X-rays.

Cartilage is Radiolucent & cannot beCartilage is Radiolucent & cannot beseen on X-rays.seen on X-rays.

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SKELETAL TRAUMA.SKELETAL TRAUMA.

One of most common causes of X-ray request.One of most common causes of X-ray request.

Bones are excellently visualized on X-rays.Bones are excellently visualized on X-rays. Cartilage, muscles & tendons cannot beCartilage, muscles & tendons cannot be

visualized on X-rays.visualized on X-rays.

Trauma to these structures can be assessedTrauma to these structures can be assessedindirectly.indirectly.

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GENERAL PRINCIPLES OFGENERAL PRINCIPLES OF

SKELETAL RADIOLOGY.SKELETAL RADIOLOGY.

At least 2 views at right angles should be taken.At least 2 views at right angles should be taken.

Supplementary views can be taken, if needed.Supplementary views can be taken, if needed.

Near by joint should be included in the radiograph.Near by joint should be included in the radiograph.

Good quality radiograph shows bony trabeculaeGood quality radiograph shows bony trabeculaeclearly.clearly.

Over &under exposed films are avoided.Over &under exposed films are avoided.

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RADIOLOGICALRADIOLOGICAL

EXAMINATION PERMITSEXAMINATION PERMITSASSESSMENT OF:ASSESSMENT OF:

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3- ASSOCIATED SOFT3- ASSOCIATED SOFT

TISSUE INJURY.TISSUE INJURY.

Joint effusion.Joint effusion.

Fat pad sign.Fat pad sign.

Surgical emphysema.Surgical emphysema.

Presence of foreign body.Presence of foreign body.

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TYPES OF FRACTURES:TYPES OF FRACTURES:

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FATIGUE/ STRESSFATIGUE/ STRESS

FRACTURESFRACTURES

Repeated minor trauma e.g. Marching.Repeated minor trauma e.g. Marching. Especially in metatarsals, tibia & fibula.Especially in metatarsals, tibia & fibula.

Produces marked callus formation.Produces marked callus formation.

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PATHOLOGICAL FRACTURESPATHOLOGICAL FRACTURES

#Secondary to bone diseases e.g.#Secondary to bone diseases e.g.

Osteoporosis.Osteoporosis.

Hyperparathyroidism.Hyperparathyroidism.

Multiple myeloma.Multiple myeloma.

Tumors.Tumors.

Osteomyelitis.Osteomyelitis. Bone cysts.Bone cysts.

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COMLICATIONS OFCOMLICATIONS OF

FRACTURES:FRACTURES:

1) Delayed Union.1) Delayed Union. Still mobile after 4Still mobile after 4

months.months. 2) Non Union.2) Non Union. No callus.No callus. Rounding &Rounding &

sclerosis of bonesclerosis of bone margins.margins.

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COMLICATIONS OFCOMLICATIONS OF

FRACTURES:FRACTURES:

3) Necrosis.3) Necrosis. Mostly due to lossMostly due to loss

of blood supply.of blood supply. Head of femur.Head of femur.Scaphoid.Scaphoid. Lunate.Lunate. Body ofBody of

talus.talus.

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COMLICATIONS OFCOMLICATIONS OF

FRACTURES:FRACTURES:

4) Malunion.4) Malunion. Malalignment.Malalignment.

Shortening.Shortening.Angulation.Angulation. 5) Joint complications.5) Joint complications. Dislocation.Dislocation.

Hemorrhage/Hemorrhage/ effusion.effusion.

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COMLICATIONS OF

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COMLICATIONS OFCOMLICATIONS OF

FRACTURES:FRACTURES:

6) Fat embolism.6) Fat embolism. Esp. after fracturesEsp. after fractures ofoflong bones.long bones.

Occlusion ofOcclusion of capillaries of lungscapillaries of lungs & brain by& brain by

fatfat globules.globules.

7) Myositis Ossificans.7) Myositis Ossificans.

8) Osteoarthrosis.8) Osteoarthrosis.

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4- AGE & HEALING OF4- AGE & HEALING OF

FRACTURES:FRACTURES:

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#Tubular Long Bones:#Tubular Long Bones:

Haematoma formation.Haematoma formation.

Cellular proliferation of subperiosteal &Cellular proliferation of subperiosteal &endosteal bone.endosteal bone.

Soft callus formation.Soft callus formation.

Consolidation of callus.Consolidation of callus.

Remodeling.Remodeling.

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# Cancellous Bone:# Cancellous Bone:

Haematoma formation.Haematoma formation.

Bridging new bone.Bridging new bone.

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BONE UNION:BONE UNION:

In children4-6 weeks for consolidation.In children4-6 weeks for consolidation.

In adults4-6 months for consolidation.In adults4-6 months for consolidation.

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