upper extremity pathology

Radiographic Pathology of the Upper Extremity

Jeff Ahrendsen

Dennis Winders

Healing FractureStage I

Healing Fracture Stage II

Healing Fracture Stage III

Healed Fracture Stage IV

Amputated 3rd distal phalanx

• Third digit was caught in a snow blower.

Amputated tuft of 1st digit

• The thumb was caught in an auger.

Soft tissue injury, with no bony involvement.

Dislocated 5th CM jt.

Dislocated 2nd DIP jt.

• This is a classic injury caused by catching a baseball.

• Note the avulsion fracture.

Dislocated Elbow

Dislocated Lunate

Dislocated 3rd PIP jt.

Dislocated 5th PIP jt.

• Monteggia fracture

Avulsion fracture

Boxers fracture

Colles fracture

Comminuted fracture of the tuft of the 3rd digit

Complete (Transverse) fracture

Spiral fractures

Obliquely oriented hairline fractures

Impacted fracture

Severe impaction

Navicular fracture

• The “waist” of the navicular is fractured.

• Note the difference in densities of the fracture fragments. This is caused by Aseptic necrosis.

Nightstick fracture

Open fracture

Radial head fracture

Radial head fracture

• This shows the importance of proper positioning.

• The partial flexion with the humerus parallel does not demonstrate the fracture.

Radial head fracture demonstrating the “fat pad sign”

Supracondylar fracture

Multiple forearm fractures

• Severely displaced fractures of the distal humerus radius, and ulna.

Severe soft tissue laceration

Pisiform fracture

Gaynor Hart

Greenstick fracture

“Bow” fracture

Note the cortical andimpactedfractures.

Torus fracture

Salter-Harris Type 1 fracture

• The type 1 fracture is indicated by a dislocation of the epiphysis.

Salter-Harris Type 2 fracture

• The type 2 fracture is indicated by a fracture of the metaphysis.

• Note the spiral fracture of the 2nd metacarpal.

Child Abuse

• This was a healing fracture that was re-broken.

• Note the periosteal callus formation (arrows).

Polydactyly

Multiple fractures & dislocations

Pre-op & Post-op joint replacement

Gunshot wound

2nd & 3rd digits nailed together

Fracture of the distal radius

• Fracture indicative of child abuse

Humeral Fracture

• Fracture indicative of child abuse

Gunshot wound

Ewings Sarcoma