Accident and Emergency Radiology: A Survival Guide

Pelvis

Regularly overlooked injuries ▪ Undisplaced acetabular fracture. ▪ Detached acetabular fragment in a patient with a dislocated hip. ▪ Sacral fractures. ▪ Avulsed apophysis from the proximal femur or from the innominate bone. The standard radiograph AP view . Abbreviations…

Thoracic & lumbar spine

Regularly overlooked injuries ▪ Transverse process fractures. The standard radiographs Lateral and AP views. Abbreviations AP, anterior-posterior; L1, the 1st lumbar vertebra; T6, the 6th thoracic vertebra. Normal anatomy Lateral view—thoracic and lumbar vertebrae ▪ The vertical contour of the…

Cervical spine

Regularly overlooked injuries The most common causes of a missed C-spine abnormality are failure to adequately visualise the injured region and inadequate understanding of the C1/C2 anatomy. Therefore errors commonly relate to: ▪ C1/C2 fractures or subluxations. ▪ Low C-spine…

Hand & fingers

The standard radiographs Depends on site of injury: ▪ Injury to a metacarpal or several phalanges: PA of hand and oblique of entire hand and wrist . ▪ Injury to the thumb or to a single digit: PA and lateral…

Wrist & distal forearm

Regularly overlooked injuries ▪ Undisplaced fracture of distal radius. ▪ Dislocation involving the lunate. ▪ Greenstick fracture. ▪ Triquetral fracture. The standard radiographs PA , Lateral , Scaphoid series . Abbreviations AVN, avascular necrosis; C, capitate; L, lunate; PA, posterior-anterior…

Adult elbow

A child's developing skeleton is vulnerable to specific elbow injuries unlike those that affect an adult. Paediatric elbow injuries are dealt with separately in Chapter 7 . The standard radiographs ▪ AP view in full extension. ▪ Lateral with 90°…

Paediatric elbow

Regularly overlooked injuries ▪ Undisplaced supracondylar fracture. ▪ Fracture, lateral condyle of humerus. ▪ Monteggia injury . The standard radiographs AP in full extension. Lateral with 90 degrees of flexion. Abbreviations CRITOL: C apitellum, R adial head, I nternal epicondyle,…

Shoulder

Regularly overlooked injuries ▪ Dislocations/subluxations: ACJ subluxation; complete rupture of the CC ligaments; posterior dislocation of humeral head. ▪ Fractures: scapula blade; glenoid rim or humeral head as a complication of an anterior dislocation at the GH joint. The standard…

Face

The standard radiographs Midface and Orbit: one or two OM views ; occasionally with a lateral view . Mandible: OPG , preferably with a PA view. Regularly overlooked injuries ▪ Tripod fracture. ▪ Blow-out fracture. ▪ TMJ dislocation. ▪ Mandibular…

Adult skull

Following a head injury the imaging examination of choice is CT . Plain film skull radiography (SXR) has in the main been abandoned or its use radically reduced as a first line imaging test both in children and in adults…