1 / 32

Lower Extremities

Lower Extremities. Third Part. Dr Mohamed El Safwany , MD. Intended Learning Outcomes. The student should be able to understand radiological aspects related to lower limb trauma. Hip. Xray views AP and “frog legs” (abducted) Lateral views hard to interprete

chiku
Download Presentation

Lower Extremities

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Lower Extremities • Third Part Dr Mohamed El Safwany, MD.

  2. Intended Learning Outcomes • The student should be able to understand radiological aspects related to lower limb trauma.

  3. Hip • Xray views • AP and “frog legs” (abducted) • Lateral views hard to interprete • Evaluate the relationship of femoral head to the acetabulum • Look for cortical discontinuities • Look at trabecular pattern

  4. Hip dislocations • From M V Accidents • Most common posterior dislocation • On AP - head of femur located superiorly and laterally displaced • Anterior dislocation: inferior and medial • Look for associated fracture fragments from the acetabulum

  5. Hip dislocation Posterior dislocation: Head of the femur superior and laterally located Anterior dislocation: Head of femur located inferiorly and medially to the acetabulum

  6. Hip Dislocation • posterior dislocation

  7. Acetabular Fracture

  8. Pelvic Fracture Open Book fx

  9. Hip fractures • Femoral neck - Osteoporotic • Unable to walk after a fall • Little deformity • Intertrochanteric - post traumatic • Shorter leg in internal rotation • Stress fracture is difficult to detect in elderly • Non displaced fracture is better seen • MRI • Bone scan ( may take several days to show)

  10. Intertrochanteric fracture

  11. Hip Fracture Hip fracture classifications most often are based on their anatomic locations: head, neck, intertrochanteric, trochanteric, and subtrochanteric

  12. Hip & Proximal Femur Fractures • Femoral head fractures • These usually are associated with hip dislocations. Superior femoral head fractures normally are associated with anterior dislocations, while inferior femoral head fractures are associated with posterior dislocations. • Type 1 - Single fragment fractures • Type 2 - Comminuted fractures • Femoral neck fractures • Type 1 - Stress fractures or incomplete fractures • Type 2 - Impacted fractures • Type 3 - Partially displaced fractures • Type 4 - Completely displaced or comminuted fractures • Intertrochanteric fractures • Type 1 - Single fracture line; no displacement; considered stable • Type 2 - Multiple fracture lines or comminution; displacement; unstable • Trochanteric fractures • Type 1 - Nondisplaced fractures • Type 2 - Displaced fracture; greater than 1 mm displacement for greater trochanteric fractures and greater than 2 mm displacement for lesser trochanteric fractures Subtrochanteric fractures • Stable - Bony contact of medial and posterior femoral cortices • Unstable

  13. Femoral Head Femoral Neck Intertrochanteric Trochanteric 

  14. Hip & Proximal Femur fracture Leg is shortened and externally rotated

  15. Aseptic necrosis hips • Xray changes • Flattening, irregularity, sclerosis of superior aspect femoral head(late) • Early findings on MRI/bone scan • Caused by trauma and chronic steroid use

  16. Aseptic necrosis of the hips

  17. X Ray MRI

  18. Slipped Capital Epiphysis • Cause unknown • Does not occur before age 9 y • Overweight teenage male • Radiographic diagnosis • Thickened epiphyseal plate • Medial displacement of the femoral head relative to the femoral neck • Lateral and frog leg views used for diagnosis

  19. Slipped Capital Epiphysis

  20. Osgood - Schlatter disease • Traumatic tibial lesion in children • Avultion fracture of the anterior tibial tuberosity • Frequent in active boys participating in sports • Pain • Age 10-15 y • Heals with rest

  21. Osgood - Schlatter disease

  22. Legg-Perthes disease(aseptic necrosis of the femoral head) • Boys more than girls • Limp + pain + limited movement of the hip • Irregularity , sclerosis and fragmentation of epiphysis • Resulting deformity with OA after a few decades

  23. Legg-Perthes disease(aseptic necrosis of the femoral head)

  24. Question • State radiographic features of O’sgoodSchlatter disease?

  25. Assignments • 5 Students will be selected for assignments.

  26. Suggested Readings • Sutton’s Radiology

  27. Thank You

More Related