Upper extremity week 9 lecture #3-A PATHOLOGY & POSITIONINGPosition? Taken For ?PowerPoint PresentationSlide 4Slide 5Problem ?Slide 7Slide 8Slide 9Slide 10Age? Positioning?Slide 12Slide 13Slide 14Slide 15Slide 16Slide 17Slide 18Slide 19Image review from ElsevierAcceptable for scaphoid?Slide 22Positioning error?The separation of the proximal radius and ulna indicates that the elbow was rotated from a true AP projectionSlide 25Slide 26PATHOLOGY? fxSlide 29?Slide 31Rheumatoid Osteo ArthritisRHEUMATOID ARTHRITISRheumatoid arthritisOsteoarthritis of fingers. Note narrowing of interphalangeal joints with spurring and erosionsSlide 36Transradial styloid perilunate fracture-dislocationFracture of the trapezium (greater multangular)greenstickTorus /buckle fxTorus or BuckleSlide 42Slide 43Colles’ FractureSlide 45Slide 46SMITH’S FXSlide 48Slide 49Slide 50Slide 51Fat pad sign w elbow injury5yo fell off swingset not 90º flexedMonteggia fracture- disclocation of radial head and displaced fx of ulnar shaftSlide 55Slide 56Subtle radial head fxA swollen elbow usually contains a fracture injury. In some instances, a joint effusion (posterior fat pad sign or enlarged anterior fat pad sign) can be seen in the absence of a visible fracture.Slide 59Slide 60the other oblique view shows an obvious fracture of the lateral (external) condyle.Lateral condlye fxSlide 63Slide 64Slide 65Slide 66SIMPLE BONE CYSTSlide 681UpperUpper extremity extremityweek 9 week 9 lecture #3-Alecture #3-APATHOLOGY &PATHOLOGY &POSITIONINGPOSITIONING RT 123 FALL 2011 REVISED12Position? Taken For ?233445A-SHOWSINSUFFICIENTROTATION56Problem ?6778B- OVER FLEXED, HAND NOT LATERAL (ROTATION)899101011Age? Positioning?111212131314141515161617171818191920Image review from ElsevierFall 20082021Acceptable for scaphoid?•Why or why not21222223Positioning error? 2324The separation of the proximal radius and ulna indicates that the elbow was rotated from a true AP projection 2425•The humerus and forearm are not in the same parallel plane to the IR (epi’s)• and the elbow is extended beyond 90°.•(?) 25262627PATHOLOGY2728? fx28292930 <> ?3031 <> 31Bennett's fracture•is caused by forced abduction of the thumb •there is a dislocation of the base of the first metacarpal although a fragment continues to articulate with the trapezium.32Rheumatoid Osteo Arthritis3233RHEUMATOID ARTHRITIS33Rheumatoid arthritis 34RA - inflammatory disease3x more common in femalesOsteoarthritis of fingers. Note narrowing of interphalangeal joints with spurring and erosions 35OA - Non inflammatory joint disease involves the articular cartilage – Aging /erosion363637Transradial styloid perilunate fracture-dislocation 3738Fracture of the trapezium (greater multangular) 3839greenstick3940Torus /buckle fx4041Torus or BuckleImpacted fracture with bulging of the periosteum.4142Which carpel bone is the most common for fracture?42434344Colles’ Fracture Extension-Compression Fracture of Distal Radius FX WITH POSTERIORDISPLACEMENT4445 <> ?45464647SMITH’S FXFlexion-Compression FX WITH ANTERIORDISPLACEMENT474848Colle's fractures usually occur when an adult falls on a hyperextended, outstretched hand. There is frequently an associated fracture of the ulnar styloid. Secondary degenerative arthritis may develop at the wrist joint. 49Same as Colles except there is volar displacement and angulation of the distal fragment5050515152Fat pad sign w elbow injury52535yo fell off swingset not 90º flexed5354Monteggia fracture-disclocation of radial head and displaced fx of ulnar shaft545555565657Subtle radial head fx5758A swollen elbow usually contains a fracture injury. In some instances, a joint effusion (posterior fat pad sign or enlarged anterior fat pad sign) can be seen in the absence of a visible fracture. 585959606061the other oblique view shows an obvious fracture of the lateral (external) condyle.6162Lateral condlye fx62636364646565666667SIMPLE BONE CYST6768Practice in LABSIGN UP =MONDAYTUESDAYWED – NOTE:NO LAB BEFORE