The atlantoaxial distance exceeds 2. If this was a patient from the polar regions then the appearances might be the result of severe frostbite damage to the bones and soft tissues from prolonged cold. It appears as a well defined lytic lesion with a thin sclerotic border. The appearance and nature of this mineralization, known as periosteal reaction or periosteal new bone formation is frequently helpful in limiting the number of hypothetical diagnoses. It is important that, in a case of suspected spinal injury, the radiographs are obtained with the minimum amount of patient movement. This is usually associated with a rupture of the anterior cruciate ligament fig 4. In the young patient these lesions are usually benign e.
They can occur at any site with equal incidence in the upper, mid and lower thirds fig 4. Road accidents, especially with motor-cycles are one of the commonest causes of major fractures of the tibia and fibula. S3 Disorders of the Lymphoreticular System 8. This condition is called spondylolisthesis see Chapter 4. This injury causes bilateral superior and inferior pubic rami fractures fig 4.
It is more common in some parts of the world than in others. Imaging techniques, radiologic symptoms and clinical conditions are treated separately. A line drawn along the shaft of the right femur intersects the acetabulum. The multiple form polyostotic fibrous dysplasia may be associated with skin pigmentation and precocious puberty in young females Albright's syndrome. This type of injury is more serious and, being unstable, frequently requires internal fixation. Note the two fallen fragments of cortical bone in the lower portion of the lesion. Periarticular reduced bone density often represents inflammatory disease, both infective and non-infective causes.
The most important differential diagnosis to an early Ewing's sarcoma is acute osteomyelitis. Permeative bone destruction with a wide zone of transition may resemble a primary sarcoma or metastasis. They occur in the first and second decades slightly more often in long bones than in the flat ones. If decreased, is it localised or generalized? Child with congenital dislocation of the right hip. There is loss of the medial joint space, subchondral sclerosis and marginal osteophyte formation. Following skeletal fusion, subarticular lesions, analogous in the adult to the epiphysis, include giant cell tumour, intraosseous ganglion and the rare clear cell chondrosarcoma. The individual responsible for interpreting the radiograph should first ensure the following; Figure 1.
Digital master created according to Benchmark for Faithful Digital Reproductions of Monographs and Serials, Version 1. On the lateral b there is an oblique fracture across the posterior aspect of the tibia with minor separation of the growth plate anteriorly. Musculoskeletal diseases - radiography 3. The radiographic appearance is a well defined lytic lesion within the medulla of long bones containing variable amounts of calcification. Category: Medical Author : Sandström S. Sometimes called raindrop lesions in the skull vault fig 8. An osteophyte-like overhanging lip to the erosions is characteristic of gout.
Purely lytic metastases are mostly originating in descending order from carcinoma of the lung, the kidney, the breast or the thyroid gland fig 9. As a result the patella is displaced inferiorly. Fragment of a needle embedded in the foot A second lateral radiograph is needed to localize the needle. There is also expansion of the affected bone with abnormally coarsened trabeculae. Accurate localisation of an abnormality frequently requires two radiographs obtained at right angles to one another e. .
Isbn 9789241546775 Other physical details ill. Overlapping of the occiput or teeth can simulate an odontoid process fracture on this view. The differential diagnosis includes Paget's disease, myeloma and metastases. The spectrum of injuries is illustrated in figure 4. In these areas, leprosy would be a much more likely explanation for the bone destruction. The whole right upper limb and shoulder girdle have been surgically removed as treatment for an advanced sarcoma. The metal in the soft tissues behind the spine was an unsuccessful attempt at occipito-cervical fusion.
There is a mixed pattern of lysis and sclerosis. Other bone infection foci are likely. Small lesions are known as fibrous cortical defects. Large paravertebral abscess with later calcification and multiple level involvement is often seen 5. On the other hand, were this a patient from tropical Africa or the Indian subcontinent the possibility of frostbite would be extremely remote.