Contributors ................. Foreword ................... Preface

Chapter 1

. xiii

. . XV

xvii

......................................................... HERPES ENCEPHALITIS 79 CEREBRAL ABSCESS ....................... .. ............................. 8 2

ACUTE DISSEMINATED ENCEPHALOMYELmS ...................... 84 IDIOPATHIC INTRACRANIAL HYPERTENSION/PSEUDOTUMOR CEREBRI ......................... 86

HEAD AND FACIAL TRAUMA ..................... 1 IblT'RACRANlAL fi4ETASTATIC LESIONS ................................. 88 ................................................................ Megan Kay Strother a Matthew D . Dobbs HYDROCEPHALUS 90

......... ............................. m Lawrence B . Stack GLIOBLASTOMA MULTIFORME .. 9 2 MENINGIOMA .................................................................. -94

EPIDURAL HEMATOMA ...................................................... 2 ENCEPHALOMACIA ............................................................. 95 SUBDURAL HEMATOMA ............................. ... .................... 6 CHIAN MALFORMATION .................................... 9 6 TRAUMATIC SUBARACHNOID COLLOID CYST ..................................................................... 98

HEMORRHAGE (tSAH) ...................................................... 10 CEREBRAL EDEMA .............................................................. 1 3 CEREBRAL CONTUSION ........................................................ 16 TRAUMATIC AXONAL INJURY ........................................... 1 8

HERNlATlON SYNDROMES ................................................... 2 4 CONVEXITY (CRANIAL VAULT) SKULL FRACTURES ............... 28 ALVEOLAR RIDGE FRACTURE .............................. .. ................ 3 1 BASILAR SKULL FRACTURE ................................................... 32 ZYGOMATlCOMAXlLLARY COMPLEX FRACTURES ............... 36 MIDFACE (LE FORT) FRACTURES ...................................... ,..+A0

NASAL BONE FRACTURES .................................................... 45 MANDIBULAR FRACTURES ............................ .... ............ 46

.................................................. ORBITAL WALL FRACTURES 49 GLOBE INJURIES ................................................................. 52 EXRACONAL HEMATOMA ................................................. 55

Chapter 2 ATW\UMATIC CONDITIONS OF THE HEAD AND FACE ......................... 57 Matthew D . Dobbs rn Cnmiron L . Pfennig m Dorris Elise Powell-Tyson rn Cari L . Buckingham

Atraumatic Conditions of the Head and Brdn ............................................ 58

ISCHEMIC STROKE ............................................................... 58 HEMORRHAGIC STROKE ..................................................... -62

ATRAUMATIC SUBARACHNOID HEMORRHAGE ................. 64

UNRUPTURED INTRACRANIAL ANEURYSM .......................... 66

ARTERIOVENOUS MALFORMATION ..................................... 70 DURAL SINUS AND CEREBRAL VEIN THROMBOSIS .............. 7 2 CAVERNOUS SINUS THROMBOSIS ....................................... 74

MOYAMOYA DISEASE ........................................................ 76 NEUROSARCOIDOSIS ........................................................... 7 8

Atraumatic Conditions of the Face..,. . ..,......,. 99 PRE-SEPTAL CELLULlTlS ........................................................ 99 ORBITAL CELLULmS .......................................................... 100

OPTIC NEURITIS .................................................................. 101

ORBITAL PSEUDOTUMOR .................................................. 102 POTT'S PUFFY TUMOR ........................................................ 103

ODONTOGENIC ABSCESS ...................................... 2 SINUSITIS ................. .. ................................................... 1 0 6 MASTOIDITIS ..................................................................... I08 DACROCYSTOCELE/NASOLACRIAL

DUCT OBSTRUCIION ....................................................... 109 MANDIBULAR DISLOCATION ............................................. 110

Chapter 3 SOFT' TISSUE CONDmONS OF THE NECK ........................... .. ........ 111 Matthew D . Dobbs 8 Marc Mickiewiu 8 Cari L . Buckingharn

LARYNGEAL FRACTURE ................................................... 1 1 2

PENETRATING INJURY TO CAROTID ARTERY ....................... 113 TRAUMATIC CAROTID ARTERY DlSSECllON ....................... 114 LUDWIG'S ANGINA ........................................................... 116

TRACHEAL DISRUPTION ................................. .. .............. 118 PERITONSILLAR ABSCESS ................................................... 119 RETROPHARYNGEAL ABSCESS ........................................... 122 CERVICAL LYMPHADENITIS ............................................... 124 PAROTITIS .......................................................................... 1 2 6 SUBMANDIBULAR SIALOLITHIASIS ................................... 128 THYROGLOSSAL DUCT CYST ...................................... 1 2 9

BRANCHIAL CLEFT CYST .................................................. 130 LYMPHATIC MALFORMATION (ALSO KNOWN

AS LYMPHANGIOMA OR CYSTIC HYGROMA) .................. 132

viii i. CONTENTS

EPIGLOllTllS ................................................................. 1 3 4 EMPYEMA ........................................................................ 192 CROUP ............................................................................. 1 3 5 PULMONARY ABSCESS ................................................. 194 LYMPHOMA ....................................................................... 136 TUBERCULOSIS ................................................................. 196 CAROTID ARTERY STENOSIS ............................................. 1 3 8 ESOPHAGEAL RUPTURE ..................................................... 198 LINGUAL ABSCESS ........................................................... 1 4 0 PNEUMOPERICARDIUM AND

PNEUMOMEDIASTINUM .................................................. 200

Chapter 4 TRAUMAnC CONDmONS OF THE CHEST ........................................ 141 Joseph Blake Charles Seamens R Jason Thurman

STERNAL FRACIURE ........................................................... 142 STERNOCLAVICULAR JOINT DISLOCATION ......................... 144 RIB FRACTURES ................................................................... 146 SCAPULOMORACIC DISSOCIATION ................................. 147 FLAIL CHEST ....................................................................... 1 4 8 PULMONARY CONTUSION ................................................ 1 5 0 DIAPHRAGMATIC RUPTURE ................................................ I52 PNEUMOTHORAX ............................................................ 1 5 4 HEMOTHORAX ................................................................ 156 PNEUMOMEDIASTINUM .................................................... 158 TRACHEOBRONCHIAL DlSRUlllON ................................... 160 AORTIC DISRUPTION ........................................................ 162

Chapter 5 A T R A U W C CONDmONS OF THE CHEST ........................................ 165 Christopher Kuzniewski Christie Sullivan Kurt A . Smith

HIATAL HERNIA ............................................................... I66 NIPPLE SHADOW .............................................................. 168 ATELEClASIS ...................................................................... 170 DEXTROCARDIA ............................................................... 173 ENLARGED CARDIAC SILHOUETTE ................................... 174 PULMONARY NODULES ................................................ 1 76 CERVICAL RIB ................................................................... 1 8 0 ASPIRATION PNEUMONIA ............................................... 18 1 LOBAR PNEUMONIA ....................................................... I 8 2 VANCELLA PNEUMONIA ................................................... 185 ACUTE CHEST SYNDROME ................................................ 186 PNEUMOCYSnS PNEUMONIA ............................................ I 8 8 ARDS: ACUTE RESPIRATORY

DISTRESS SYNDROME .................................................... 190 ATYPICAL PNEUMONIA ..................................................... 19 1

PNEUMOPERITONEUM ....................................................... 202 PNEUMOTHORAX .............................................................. 204 PLEURAL EFFUSION ............................................................ 206 SUBCUTANEOUS EMPHYSEMA .......................... .. ........... 209 PERlCARDlAL EFFUSION ........................ .. ........................ 210 PENCARDIAL TAMPONADE ............................................... 212 PULMONARY EMBOLUS (PE) ............................................. 214 ASBESTOSIS ..................................................................... 218 CONGESTIVE HEART FAILURE ............................................. 219 POST-OBSTRUCTIVE PNEUMONIA ...................................... 222 PRIMARY LUNG CANCER ................................................... 224 METASTATIC DISEASE TO LUNG ........................................ 228 PULMONARY FIBROSIS ..................................................... 231 CHRONIC OBSTRUCTIVE

PULMONARY DISEASE ................................................... 232 .................................................................... SARCOIDOSIS 234

CYSTIC FIBROSIS ................................................................. 237 AORTIC DISSECTION .......................................................... 238 AORTIC ANEURYSM ........................................................... 240 ESOPHAGEAL INTUBATION ............................................... 243 SUPERIOR VENA CAVA SYNDROME .................................... 244 FOREIGN BODY ASPIRATION .............................................. 246 RIGHT MAINSTEM INTUBATION .............................. ... .. 248 CORONARY ARTERY STENOSIS .......................................... 249 MEDlASTlNAL MASS .................................................... -250 CARDIAC ANEURYSM ..................................................... 252 RIGHT AORTIC ARCH .......................................................... 254

Chapter 6 T R A U W C CONDITIONS OF THE ABDOMEN ................................. 257 Jake Block 8 Gary Schwartz R Jason Thurman

LNER LACERATION ............................................................ 258 SPLENIC LACERATION ........................................................ 261 PANCREATIC LACERATION ...................................... 4 BOWEL AND MESENTERIC INJURY ..................................... 266 PENETRATING INJURY ......................................................... 270 ADRENAL HEMATOMA ...................................................... 273

RENAL INJURY .............. .. ............................................. 2 7 4 BLADDER INJURY ................................................................ 2 7 6

URETHRAL INJURY ............................................................ 2 7 8 TESTICULAR TRAUMA ...................................................... -279

Chapter 7 A T R A U M C CONDITIONS OF THE ABDOMEN ................................. 28 1 jake Block Laurie M . Lawrence rn Robinson M . Ferre

ABDOMINAL AORTIC ANEURYSM (AAA) .......................... 282 EMPHYSEMATOUS CHOLECYSmS .................................... 2 8 5 ABDOMINAL FOREIGN BODIES ................................ 2 ABDOMINAL WALL HERNIA .............................................. 288 CHOLELlTHlASlS ............................................................ 2 9 0

ACUTE CHOLECYSTITIS ...................................................... - 2 9 2

ILIOPSOAS ABSCESS ......................................................... 294 ACALCULOUS CHOLECYSITIIS ........................................... 2 9 6 ACUTE CHOLANGITIS ......................................................... 298 ACUTE APPENDICITIS ......................................................... 300 DIVERTICULITIS ................................................................... 305 SMALL BOWEL OBSTRUCTION .......................................... 308 TYPHLITIS .................... .. ................................................. 3 1 1

INFLAMMATORY BOWEL DISEASE ..................................... 3 1 2

ISCHEMIC BOWEL ............................................................. 3 1 4 OVARIAN TERATOMA

(DERMOID CYST) .......................................................... 3 1 7

COLON CARCINOMA ....................................................... 3 1 8 GASTROINTESTINAL PERFORATION ................... ......... ........ 3 2 0 VOLVULUS ......................................................................... 3 2 2 PANCREATmS ................................................................... -324 LIVER METASTASIS ............................................................. 3 2 7 UTERINE FIBROID ................................................................ 328 OVARIAN TORSION ............................................................ 330 TUBO-OVARIAN ABSCESS .................................................. 3 3 2

OVARIAN CYST ................................................................... 334 EARLY INTRAUTERINE PREGNANCY .................................... 336 ECTOPIC PREGNANCY ....................... .. ............................ 3 4 2 MOLAR PREGNANCY ....................................... L RENAL CELL CARCINOMA ......................................... 34G EPIDIDYMmS ...................................................................... 347 PYELONEPHRmS ................................................................ 348

RENAL ABSCESS ................................................................. 350 OVARIAN CANCER ............................................................. 35 1 UROLITHIASIS .................................................................... 3 5 2

Chapter 8 PELVIC TRAUMA ..................................... 355 David S . Taber Michael N . Johnston

ACETABULAR FRACTURES ................................................. -356 UNILATERAL SUPERIOR AND

INFERIOR RAMUS FRACTURES .......................................... 3GO BILATERAL SUPERIOR AND

INFERIOR RAMUS FRACTURES .......................................... 361 APOPHYSEAL AVULSION FRACTURES ................................ 3 6 2 PUBIC SYMPHYSIS DIASTASIS ............................. d I L K WING FRACTURE

(DUVERNEY FRACTURE) .................................................... 365 ............................ SACRAL FRACTURES

PELVIC RING FRACTURES ............................. .. ................ 3G8

SACRAL INSUFFICIENCY FRACTURE ................... .... ...... 3 7 2 PUBIC INSUFFICIENCY FRACTURE ........................................ 374

............................................................ COCCYX FRACTURE 3 7 5

Chapter 9 .................................. UPPER ExnEMtTY 377

Martin I . Jordanov I Robert-Warne Fitch

Shoulder ...................................................... 378 ACROMIO-CLAVICULAR SEPARATION ............................... 3 7 8

.............................. ACROMlAL FRACTURE

Glenohumeral Joint ...................................... 382 ANTERIOR GLENOHUMERAL DISLOCATION ...................... 3 8 2 POSTERIOR CLENOHUMERAL DISLOCATION ..................... 384

............................... LWVinO ERECTA .. CALClFlC TENDONITIS ........................................................ 387

........................................................ SCAPULAR FRACTURE 388 CLAVICLE FRACTURES ......................................................... 390

STERNOCLAVICULAR DISLOCATION .................................. 3 9 2

Elbow .......................................................... 394 RADIAL HEADINECK FRACTURE ....................................... 394 OLECRANON FRACTURE ............................................... 3 5 MEDIAL EPICONDYLE FRACTURE ...................................... 396

........................... SUPRACONDYLAR FRACTURES 4 8 ELBOW DISLOCATIONS ..................................................... 400

Humerus ..................................................... 401 PROXIMAL HUMERAL FRACTURES ..................................... 401

HUMORAL S H A n FRACTURES ........................................... 4 0 2

x CONTENTS

Forearm ....................................................... 404 GALEAZZI FRACTURE-DISLOCATION ................................. 404 MONTEGGIA FRACTURE-DISLOCATION .............................. 405 RADIUS/ULNA FRACTURES

(BOTH BONE FOREARM FRACTURES) .............................. 4.06

Wrlst Injuries .............................................. 407 COLLES' FRACTURE ............................................................ 4 0 7 SMKH FRACTURE .............................................................. 408 HUTCHINSON'S FRACTURE ................................................. 409

Carpal Bone Fractures .................................. 4 1 0 SCAPHOID FRACTURE ...................................................... 4 1 0 SCAPHO-LUNATE LIGAMENT TEAR ............................... ... .. 4 1 2 TRIQUETRAL FRACTURE ................................................. 4 1 3 HAMATE FRACTURE ......................................................... 4 1 4 CAPITATE. HAMATE. AND PISIFORM FRACTURES ............... 4 1 5 PERILUNATE DISLOCATION ............................................. 4 6 LUNATE DISLOCATION ..................................................... 4 1 7

Hand ...................................................... 41 8 METACARPAL FRACTURES ............................................. 4 8 PHALANX FRACTURE ...................................... L O TUFT FRACTURE .................................................................. 421 VOLAR PLATE AVULSION FRACTURE .................................. 4 2 2 MALLET FINGER ............................................................... 4 2 3 GAME KEEPER'S/SKIER'S THUMB ..................................... 424 BENNEW FRACTURE ...................... .. ................................ 4 2 5 ROLAND0 FRACTURE ......................................................... 4 2 6 THUMB DISLOCATIONS ..................................................... 4 2 7 FINGER DISLOCATIONS ...................................................... 4 2 8

Miscellaneous Causes of Pain ....................... 429 DEEP VEIN THROMBOSIS ................................................. 4 2 9 ARTHRITIS .......................................................................... 430 INFECIION ....................................................................... 4 3 2 VASCULAR ARTERIAL INJURY ........................................... 434 NEOPLASMS ...................................................................... 436

Chapter 10 LOWER EXTREMITY ................................. 439

- -

Martin I . Jordanov 8 James F . Fiechtl

Hip .............................................................. 440 HIP DISLOCATION ............................................................ 440 FEMORAL HEAD FRACTURES (PIPKIN FRACTURES) ............. 441 SUBCHONDRAL FRACTURE FEMORAL HEAD ..................... 4 4 2

FEMORAL FRACTURE-SUBCAPITAL .................................. 443 FEMORAL HEAD OSTEONECROSIS ..................................... 444

FEMORAL NECK STRESS FRACTURE .................................... 446 PUBIC RAM1 STRESS FRACTURES ......................................... 447 GREATER TROCHANTER FRACTURE ..................................... 448 LESSER TROCHANTER AVULSION

FRACIURE FROM A METASTASIS ...................................... 449 INTERTROCHANTERIC FEMORAL FRACTURE ....................... 450 FEMORAL SUBTROCHANTERIC FRACTURE ....................... 4 5 2 PERIPROSTHETlC FRACTURE-TOTAL

HIP ARTHROPLASN ........................................................ 453 PERIPROSTHETIC LOOSENING ............................................ 4%

BISPHOSPHONATE FRACTURE ............................................ 456 ...................................................... FEMORAL FRACTURES 4 5 7

FEMORAL FRACTURE-BALLISTIC ...................................... 458 SUPRACONDYLAR FEMUR FRACTURE ................................. 459

FEMORAL FRACTURE-PATHOLOGIC ................................. 460 PERIPROSTHETIC FRACTURE-TOTAL

KNEE ARTHROPLASN ..................................................... 4 6 2 KNEE DISLOCATION ...................................................... 463 ANTERIOR CRUClATE LIGAMENT TEAR

INDICATORS-SEGOND FRACTURE, DEEP SULCUS, AND ANTERIORTlBlAL SPINE AVULSION .......... 464

POSTEROLATERAL CORNER INJURY .................................... 468 MENISCAL TEARS .............. .. .......... .. ............................. 469 POSTERIOR CRUCIATE LIGAMENT (PCL)

AND MEDIAL COLLATERAL LIGAMENT (MCL) TEAR ....... 4 7 0 OSTEOCHONDRITIS

DlSSECANS/OSTEoCHONDRAL (OCD) LESIONS .............. 4 7 2 PATELLA BAJA .................................................................... 4 7 3 TIBIAL PLATEAU FRACTURES ............................................. 4 7 4 PATELLAR DISLOCATIONS ................................................. 4 7 8 PATELLAR FRACTURES ................................. .. .................. 480

MIMICKERS OF PATELLAR FRACTURES ............................... 482

PATELLA ALTA ................................................................. 484

OSGOOD-SCHLATTER DISEASE ......................................... 485 TIBIAL SHAFT FRACTURES .................................................. 486

................................ MAISONNEUVE INJURY A 7 TIBIAL STRESS FRACTURES .................................................. 488 PlLON FRACTURE ................................................................ 490 EVERSION INJURY OF THE ANKLE ...................................... 491

ANKLE FRACTURES ............................................................. 492 INVERSION INJURY OF THE ANKLE .................... .. ............ 495

TRlPLANE FRACTURE ........................................................ ..496 TALAR DOME FRACTURE .................................................... 4 9 7

CONTENTS v xi

TALAR DOME OSTEOCHONDRAL LESION ......................... 498

TALAR NECK FRACTURES ................................................... 499 LATERAL PROCESS OF THE TALUS FRACTURE .................. 500

SUBTALAR DISLOCATION ................................................. 501 CALCANEAL STRESS FRACTURES ........................................ 502 CALCANEAL FRACTURE WITH BOHLER'S

ANGLE FLAlTENING ....................................................... 504 CALCANEAL INSUFFICIENCY AVULSION FRACTURE ........... 505

....................................... MIDFOOT FRACTURES J LISFRANC FRACTURE.DISLOCATION ..... .. ................... ..SO8 5m METATARSAL BASE FRACTURE ...................................... 5 10

JONES FRACTURE ................. .. ..................................... 5 1 1 GREAT TOE DISLOCATION ............................................. 5 1 2 SESAMOID FRACTURES ................................................... 5 13

BIPARTITE SESAMOIDS: MlMlCKERS OF SESAMOID FRACTURES ........................... 5 14

TOE FRACTURES ............................................................. 5 1 5 ARTHRmS ........................................................................ 5 16

BONE INFARCTIONS ....................... .. ............................. 5 18 NEUROPATHIC ARTHRITIS ............................. .. ............... 5 I9 OSTEOMYELITIS OF THE GREAT TOE ................................... 520 SEPTIC ARTHRITIS ............................................................... 523 NEOPLASMS ...................................................................... 524

NECROTIZING FASCllTlS ..................................................... 527

Chapter I I PATHOLOGIC CONDITIONS OF THE SPINE ......................................... 529 Katherine G . Hartley Jason Dowling m Allison D . Bollinger

FLEXION TEARDROP FRACTURE ......................................... -530 EXTENSION CORNER AWLSION FRACTURE ....................... 53 1 ANTERIOR SUBLUXATION INJURY .................................... 532 UNILATERAL FACET DISLOCATION ..................................... 534

BILATERAL FACET DISLOCATION (JUMPED FACETS) ........... 536 CLAY SHOVELER FRACTURE ................................................ 538

JEFFERSON'S FRACTURE ...................................................... 539 HANGMAN'S FRACTURE ............................. .. ................ 540 ODONTOID FRACTURES ..................................................... 542 OCCIPITAL CONDYLE FRACTURE ........................................ 544 SIMPLE WEDGE COMPRESSION FRACTURE ........................ 545

ANTERIOR ATLANTO-AXIAL DISLOCATION ...................... 546 ATLANTO-OCCIPITAL DISLOCATION .................................. 548

CHANCE FRACTURE .......... ..... ............................... -550 TRANSVERSE PROCESS FRACTURES .................................... 552 BURST FRACTURES .............................................................. 554 SPINAL CORD NEOPLASM ................................................. 555

NEOPLASTIC SPINAL CORD COMPRESSION .................... 556 SPINAL CORD TRANSECTiON ............................................. 558

SPINAL CORD INFARCTION ........................ .. ................... 560 SPINAL CORD CONTLISION ................................................ 562

EPIDURAL HEMATOMA .................................................... 563

EPIDURAL ABSCESS ........................................................... 564 HERNIATED NUCLEUS PULPOSUS ................................... 566 DISKITIS (INFECTIOUS SPONDYLITIS) ............................... 568 TRANSVERSE MYELITIS ................................................... 570

Chapter 12 PEDIATRIC CONDITIONS ......................... 573 J . Herman Kan Mark Meredith

BRONCHIOLmS ................................................................ 574 CHILD ABUSE ..................................................................... 576

CONGENFAL DIAPHRAGMATIC HERNIA ........................... 578 CONGENITAL HEART DISEASE ........................................... 580

CROUP ........................................................................... 582

FOREIGN BODIES ................................ .. HIRSCHSPRUNG'S DISEASE ................................................ 586 INTUSSUSCEMION ............................................................ 588

MECKEL'S DIVERTICULUM .......................... .. .. .. .......... 591 NECROTlZlNG ENTEROCOLITIS ........................... .. .......... 592 OVARIAN TORSION ............................................................ 594 RETROPHARYNGEAL ABSCESS ........................................... 598 HYPERTROPHIC PYLONC STENOSIS ................................... 601

SALTER HARRIS FRACTURES ............................................... 602 ELBOW FRACTURES ......................................................... 604

TESTICULARTORSION .................................................... 608 THYMUS ..................... ... ................................................ 610 VOLVULUS ......................................................................... 612 SLIPPED CAPITAL FEMORAL EPIPHYSIS .............................. 614

Index .................................................................................. 615