![Page 1: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/1.jpg)
CT3 MSK Radiology
![Page 2: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/2.jpg)
1
![Page 3: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/3.jpg)
1• A 39y.o. goalkeeper falls over playing for
the local club.
• Name of fracture?
Galeazzi
• Distinguishing features?# Radius, Dislocated distal ulna
• “Opposite injury?”
Monteggia
![Page 4: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/4.jpg)
2
![Page 5: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/5.jpg)
![Page 6: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/6.jpg)
2
• An 89 yr old lady who has collapsed in the kitchen complaining of a stiff neck.
• 1. What is the injury?
Type 3 Odontoid peg #
• 2. Name 2 systems for clearing neck injuries.
NEXUS, Ottawa rules
![Page 7: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/7.jpg)
3a
![Page 8: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/8.jpg)
![Page 9: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/9.jpg)
3a.
• A 34 yo motorcyclist thrown from his bike at 65mph.
• Spot the injury
Crush # L4, (subtle wedge # L2)
• Is this likely to be stable or unstable?
Unstable as 2 columns are disrupted
![Page 10: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/10.jpg)
![Page 11: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/11.jpg)
3b
![Page 12: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/12.jpg)
![Page 13: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/13.jpg)
3b
The same motorcyclist also has this injury
• What is it?
True dislocation of knee
• What are the two most important management priorities (after ABC and analgesia!)
Relocation
Imaging of popliteal artery
![Page 14: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/14.jpg)
4
![Page 15: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/15.jpg)
![Page 16: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/16.jpg)
4Another knee injury – this lady fell from a
horse
• What type of # is this?Tibial plateau #
• Give three management principlesABCDE – this is a high impact injury
Analgesia – including comfort slab
Orthopaedic Referral (imaging and definitive treatment)
![Page 17: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/17.jpg)
5a
![Page 18: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/18.jpg)
5a
• 57 yr old man falls off a ladder onto hand
• Name (or describe) of #
Bennett’s fracture
• What is the definitive management?
Requires operative stabilisation
![Page 19: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/19.jpg)
5b
![Page 20: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/20.jpg)
5b
He also sustains this injury.
• In which other specific area do you look for injury?
Spine
![Page 21: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/21.jpg)
6
![Page 22: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/22.jpg)
6• A man falls off his bike straight onto his
shoulder
• Name the injuryA-C joint Dislocation
• What is the prognosis?Good
• What other potentially life threatening injury might you be able to see?
Pneumothorax
![Page 23: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/23.jpg)
7 7a
![Page 24: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/24.jpg)
7
It’s Saturday night…
• Name the xRay
Jug Handle view
• What is the fractured bone?
Left zygomatic arch
![Page 25: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/25.jpg)
7b
![Page 26: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/26.jpg)
7b
He also complains of pain in his Right hand
• What specific factor must you assess to ensure function?
Presence / absence of rotational deformity
![Page 27: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/27.jpg)
8a
![Page 28: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/28.jpg)
818 month old boy who wakes crying in the
night – may have got foot caught in cot sides
Well child, not walking on Lt leg
• Give 2 differential diagnoses?Toddler’s fracture, Hip pathology, Septic arthritis /
osteomyelitis
• What is your management?
Analgesia, make arrangements for review.
![Page 29: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/29.jpg)
8b
![Page 30: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/30.jpg)
He is seen again 2 days later. He is mardy and pale. He is not eating and “feels hot” – having regular calpol.
What 2 differential diagnoses must you consider?
Osteomyelitis
Septic Arthritis
![Page 31: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/31.jpg)
9
![Page 32: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/32.jpg)
![Page 33: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/33.jpg)
9
A 57 yr old lady falls downstairs and has a swollen foot.
• What is the name of injury?Lis-Franc Injury (T-MT # / dislocation)
• What other view do you need?True lateral xRay
![Page 34: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/34.jpg)
10
![Page 35: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/35.jpg)
10Another goalkeeper – a 10 yr old playing in
goal making a crucial save.He is now complaining of a sore wrist
• What is the diagnosis?Torus (buckle) # distal radius
• Give two management points?Splint (or PoP) for analgesia and home
Do not play football for 4-6 weeks
![Page 36: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/36.jpg)
11
![Page 37: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/37.jpg)
11
A 13 y.o. who twisted his ankle and is tender over the base of the 5th Metatarsal
• What is the diagnosis?
Ligamentous injury
![Page 38: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/38.jpg)
12
![Page 39: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/39.jpg)
12
A 27 yr old who fell off a step in a nightclub wearing high heels, and has a swollen ankle.
• What is the injury?
Fracture base of 5th Metatarsal
![Page 40: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/40.jpg)
13
![Page 41: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/41.jpg)
13
A 22 yr old on the 1st day of summer.
• What is the likely mechanism?
• Give 3 things that this man needs?
Analgesia
Tetanus / antibiotics
Urgent debridement and wound toilet
![Page 42: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/42.jpg)
14
![Page 43: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/43.jpg)
14
• Where is the abnormality?
Middle phalanx, ring finger
• What is the most likely diagnosis?
Enchondroma
![Page 44: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/44.jpg)
15
![Page 45: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/45.jpg)
15
An 8 month old baby who got her foot trapped under sofa and was unable to free herself.
She is refusing to W/B.
• What is the injury?
Toddler’s fracture (buckle fracture distal tibia)
![Page 46: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/46.jpg)
16
![Page 47: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/47.jpg)
16• What is the injury?
Fractured surgical neck of humerus
• What other structure is at risk?Axillary nerve
• Give 2 definitive ED management strategies
Collar & CuffHanging U slab
![Page 48: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/48.jpg)
17
![Page 49: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/49.jpg)
17A 67 yr old man who tripped up a kerb
• What 3 radiological signs are there?Elevated anterior fat pad
Visible posterior fat pad
Fracture radial head
• Give 2 options for pain relief?Medication
Collar & cuff
Aspiration of elbow
![Page 50: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/50.jpg)
18
![Page 51: CT3 MSK Radiology. 1 1 A 39y.o. goalkeeper falls over playing for the local club. Name of fracture? Galeazzi Distinguishing features? # Radius, Dislocated](https://reader036.vdocument.in/reader036/viewer/2022062720/56649f055503460f94c19539/html5/thumbnails/51.jpg)
18
• And finally…
Find 3 Abnormalities
Pathological fracture tibia
Missing fibula
Lucencies in distal tibia