subtle and occult fractures - royal college of radiologists · subtle and occult fractures dr m...
TRANSCRIPT
-
Scapula
Subtle and Occult Fractures Dr M Mariathas and Dr N Purohit
Department of Radiology, University Hospital Southampton
Distal Radius
Medial Clavicle
Scaphoid
Triquetral Radial Head
Pelvic – Pubic Rami and Acetabulum
Medial Patella
Anterior Calcaneal Process
Dorsal Capsular – Talus and Navicular
Medial Tibial Plateau Posterior Tibial Plateau Lateral Talar Dome
Medial Malleolus
Top Tips 1. Satisfaction of search – in cases of
multiple fractures, always search
hard for the additonal subtle and
hidden fracture.
2. Soft tissue swelling and displaced
fat pads – use these to help guide
you to a subtle fracture.
3. Understanding the mechanism of
injury – and by looking for the
frequently associated fractures.
4. Overlying structures – pay extra
attention to areas where multiple
bony surfaces overlap as fractures
can be easily missed here.
5. Ligamentous/tendinous insertion
points – avulsion injuries can often
be subtle and small.
6. Metalwork – pay extra-attention to
the surrounding bone for subtle peri-
prosthetic fractures.
7. Building ‘Review Areas’ – this can
be done by using the above tips and
knowledge of frequently missed
subtle fractures such as the ones
shown on this poster.