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Spondylolysis

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Spondylolysis SPONDYLOLYSIS = Defect in pars interarticularis portion of lamina. Etiology: Repeated Microtrauma Heredity component (hypoplastic pars) Clinical: May be asymptomatic May present with low back pain 3-7% of general population (all ages) Athletes -Increased to 23-62% Males 2-4 more than Females 95% at L5 level Bilateral pars defects can lead to spondylolisthesis XRAY Most […]

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Cervical Rib

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Cervical Rib 3 Different Cases of Cervical Ribs AKA- Supernumerary Rib or Accessory Rib Arises from the seventh cervical vertebre Rate – 0.5% of the population More common in females. Usually asymptomatic It is the most important anatomic rib variant clinically because they can result in thoracic outlet syndrome (compression of brachial plexis or subclavian […]

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Madelung Deformity Of Wrist Xray

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Madelung Deformity Of Wrist Xray Madelung deformity Premature closure or defective development of the ulnar third of the distal epiphysis of the radius Bilateral in 50-66% of patients. Often rare congenital deformity manifesting 10-14 years  (autosomal dominant- variable penetrance) Can be acquired consequence of trauma to the growth plate More common in females. Can be […]

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Stress Fracture Xrays

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Stress Fracture Xrays 2 Types: Stress Fracture Insufficiency Fracture = Normal Stress on Abnormal Bone Fatigue Fracture = Abnormal Stress on Normal Bone Stress fractures are microscopic fractures which typically do not cause macroscopic interruption of the bone. Therefore no lucent fracture line is visible on x-ray Follow up X-rays as demonstrated above will show bony […]

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Supracondylar Process

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  Supracondylar Process AKA supracondylar spur, supratrochlear spur, or avian spur Located along the distal anteromedial humeral cortex ~5 cm proximal to and pointing towards the medial epicondyle of the humerus (as opposed to an osteochondroma which points away from the joint) It is an anatomical varient present in ~1% of the population. Supracondylar Process […]

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AC Joint Separation

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                        Acromioclavicular Joint Separation Occurs in 10% of all shoulder injury; 12% of shoulder dislocations involve AC joint Mechanism –Direct fall on shoulder in adducted position with downward force on acromion- often in football, hockey, rugby players –FOOSH- force directed up to humerus and […]

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Elbow Effusion and Radial Head Fracture X-ray

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  Uplifting of the Anterior Fat Pad (Spinnaker Sail Sign) = Fracture Positive Posterior Fat Pad Sign = Fracture Positive Fat Pad Sign in Adult = Radial Head and/or Neck Fracture Positive Fat Pad Sign in Child = Supracondylar Fracture ALWAYS LOOK FOR THE FAT PAD SIGNS Anterior Fat Pad sign = Uplifting of the […]

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5th MT Dislocation Xray

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The most obvious finding is that the bases of the metacarpals do not line up. The Base of the 5 MC is proximal to the base of the 4 MC. This should be the first clue. The second clue is the marked soft tissue swelling of the hand on the lateral xray. Plus the lateral […]

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Avoid the Easy Button

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Is This a NORMAL Xray of the Hand? No? I Agree. But it was read as normal when a Radiologist “Hit the Easy Button” = “Macro Normal Right Hand” This patient complained of hand and wrist pain. The patient’s pain appears to be from their severe midcarpal row arthritis with apparent bone on bone at […]

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Kohler’s Disease X-ray

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Note the patchy fragmented markedly small and somewhat flat navicular. This reflects avascular necrosis of the Navicular in a skeletally immature patient: Kohler’s disease. This is a self-limiting entity and almost always resolves completely. It is important to alert the referring clinician to this diagnosis as on an x-ray it can be mistaken for an […]