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Fracture displacement (summary)

This is a basic article for medical students and other non-radiologists Describing fracture displacement is really important when assessing a fracture. The type and degree of displacement will have a significant effect on the management plan and prognosis. Reference article This is a summary ...

Fracture location (summary)

This is a basic article for medical students and other non-radiologists Determining fracture location is important when describing a fracture and determining plans for management. Reference article This is a summary article. For more information, you can read a more in-depth reference article...

Fractures of the proximal fifth metatarsal

The proximal 5th metatarsal is the site of a number of fractures and variants which mimic fractures. These include: stress fracture of the 5th metatarsal Jones fracture avulsion fracture of the proximal 5th metatarsal accessory ossicles os vesalianum, or os peroneum normal apophysis of th...

Fractures of the thumb

Fractures of the thumb are important due to huge impact the thumb has on the overall function of the hand, an understanding of the types of fractures that occur is important, as treatment varies with fracture type. Pathology Types Metacarpal fractures include: intra-articular fractures Benn...

Fracture translation

Fracture translation (also called translocation) describes the movement of fractured bones away from each other. In some cases, people will just use the term displacement to describe translation. However, displacement should really be used as a broad term that refers to angulation, translation a...

Frontal sinus fracture

Frontal sinus fractures are facial fractures that involve the frontal sinus, either in isolation or more commonly as part of more complex facial fractures. They can result in cosmetic deformity, functional impairment, CSF leak, and/or intracranial infection (e.g. meningitis). Epidemiology Fron...

Frykman classification of distal radial fractures

The Frykman classification of distal radial fractures is based on the AP appearance and encompasses the eponymous entities of Colles fracture, Smith fracture, Barton fracture, chauffeur fracture. It assesses the pattern of fractures, involvement of the radioulnar joint and presence of a distal u...

Galeazzi and Monteggia fracture-dislocations (mnemonic)

There are several mnemonics for the difference between a Galeazzi and a Monteggia fracture-dislocation: GRIMUS MUGR (pronounced as mugger) FROG GRUesome MURder Manchester United / Glasgow Rangers It is useful to note that it is the head of the non-fractured bone that is dislocated. Mnemon...

Galeazzi fracture-dislocation

Galeazzi fracture-dislocations consist of fracture of the distal part of the radius with dislocation of distal radioulnar joint and an intact ulna. A Galeazzi-equivalent fracture is a distal radial fracture with a distal ulnar physeal fracture 2. Epidemiology Galeazzi fractures are primarily e...

Gamekeeper thumb

Gamekeeper's thumb is an avulsion or rupture of the ulnar collateral ligament (UCL) of the thumb. It is essentially synonymous with skier's thumb, although the latter has more of an acute injury connotation. Epidemiology The repetitive breaking-of-necks of small game (rabbits and such) resulte...

Genant classification of vertebral fractures

The Genant classification of vertebral fractures is based on the vertebral shape, with respect to vertebral height loss involving the anterior, posterior, and/or middle vertebral body. grade 0: normal grade 1: mild fracture, <25% loss of height grade 2: moderate fracture, 25% to 40% loss of h...

Gilula three carpal arcs

Gilula three carpal arcs refer to the carpal alignment described on posteroanterior or anteroposterior wrist radiographs and are used to assess normal alignment of the carpus: first arc: is a smooth curve outlining the proximal convexities of the scaphoid, lunate and triquetrum seco...

Glass foreign bodies

Glass foreign bodies may be present if they are ingested, inserted, or as a result of an injury. All glass is radiopaque 7. Epidemiology The prevalence of glass foreign bodies in wounds from injury has been recorded at a rate of 1.5% in superficial (subcutaneous) wounds and 7.5% of deeper woun...

Globe rupture

Globe rupture is an ophthalmologic emergency. A ruptured globe or an open-globe injury must be assessed in any patient who has suffered orbital trauma because open-globe injuries are a major cause of blindness. In a blunt trauma, ruptures are most common at the insertions of the intraocular mus...

Gosselin fracture

The Gosselin fracture is a fracture of the distal tibia with a V-shaped fractured fragment and intra-articular involvement. History and etymology It is named after Leon Athanese Gosselin (1815–1887), a French surgeon.

Goyrand fracture

Goyrand fracture is another name for a Smith fracture (reverse Barton fracture) and is predominantly used in France or French-influenced countries. For a discussion of this fracture refer to the article on Smith fractures. History and etymology Named after Jean-Gaspard-Blaise Goyrand: French ...

Greenstick fracture

Greenstick fractures are incomplete fractures of long bones and are usually seen in young children, more commonly less than 10 years of age. They are commonly mid-diaphyseal, affecting the forearm and lower leg. They are distinct from torus fractures. Pathology Mechanism Greenstick fractures ...

Gustilo Anderson classification

The Gustilo Anderson classification, also known as the Gustilo classification, is the most widely accepted classification system of open (or compound) fractures. The grading system is used to guide management of compound fractures, with higher grade injuries associated with higher risk of compl...

Hematoma

Hematomas are the name given to localized collections of blood and they can form virtually anywhere in the body. They often form secondary to trauma or surgery but spontaneous formation is also not uncommon, especially in those with coagulation disorders or on anticoagulant therapy. Hematomas m...

Hematomyelia

Hematomyelia refers to the presence of intramedullary hemorrhage or hematoma within the spinal cord. This is distinct from extramedullary hemorrhage such as that seen in epidural hematoma. Pathology Although hematomyelia can occur in the setting of trauma, the term is generally used to signify...

Hemopneumothorax

A hemopneumothorax (plural: hemopneumothoraces) (or, less commonly, haematopneumothorax or pneumohemothorax) is a term given when there is concurrent presence of a hemothorax and pneumothorax. It is a variant of a hydropneumothorax. Epidemiology Approximately 5% of patients with pneumothorax ...

Hemotympanum

Hemotympanum is the presence of blood in the middle ear cavity. It is usually secondary to trauma. Clinical presentation Typically on otoscopy a bulging red to purple to dark blue colored tympanic membrane is visible, color varying with age of the hemorrhage. Pathology The hemorrhage has us...

Hamstring injury

Hamstring injuries are the most common muscle injury, and are very common in athletes and can cause a significant loss of playing time depending on the sport. Epidemiology Amongst professional athletes, hamstring injuries are reported to make up 15% of all injuries in Australian Football play...

Hanging and strangulation (trauma)

Hanging and strangulation are injuries involving constricting pressure applied to the neck. The vast majority are sustained as a result of attempted suicide. Epidemiology In America, hangings are the second most common form of suicide after firearm use. In other parts of the world due to the r...

Hangman fracture

Hangman fracture, also known as traumatic spondylolisthesis of the axis, is a fracture which involves the pars interarticularis of C2 on both sides, and is a result of hyperextension and distraction. Epidemiology These injuries account for 4-7% of all cervical spine fractures and up to 22% of ...

Hernia (general)

Hernias (or herniae) are a common pathological entity, in which an anatomical structure passes into an abnormal location via an opening. The opening may be a normal physiological aperture (e.g. hiatus hernia: stomach passes through the diaphragmatic esophageal hiatus) or pathological. Iatrogeni...

High-velocity penetrating brain injury

High-velocity penetrating brain injuries, in practical terms most often due to cranial gunshot injuries, are a form of penetrating traumatic brain injuries, which are much less common than blunt traumatic brain injuries and distinguished from low-velocity penetrating brain injuries (such as stab...

Hill-Sachs lesion

Hill-Sachs lesions are a posterolateral humeral head compression fracture, typically secondary to recurrent anterior shoulder dislocations, as the humeral head comes to rest against the anteroinferior part of the glenoid. It is often associated with a Bankart lesion of the glenoid. Terminology ...

Hip dislocation

Hip dislocation is a relatively rare entity and may be congenital or acquired. Epidemiology Hip dislocations account for ~5% of all dislocations 3. Pathology There are numerous patterns of dislocation 1: posterior hip dislocation (most common ~85%) anterior hip dislocation (~10%) inferio...

Holdsworth fracture

Holdsworth fracture is the eponymous name for an unstable thoracolumbar junction fracture involving the vertebral body and articular processes as well as posterior ligamentous complex rupture 1,2.

Hook of hamate fracture

Hook of hamate fractures are rare. They occur from the hamate fracturing after blunt trauma, falls, and in sports player (e.g. golf, baseball, racquet sports) from a direct blow while swinging. Stress fractures have also been reported. It may result in Guyon's canal syndrome. Differential dia...

Humeral shaft fracture

Humeral shaft fractures are readily diagnosed and usually, do not require internal fixation. Epidemiology Humeral shaft fractures account for 3-5% of all fractures 1,3. Although they occur in all age groups, a bimodal distribution is noted. The first peak is seen in the third decade in males ...

Humeral shaft fracture (summary)

This is a basic article for medical students and other non-radiologists Humeral shaft fractures are readily diagnosed and do not usually require internal fixation. Reference article This is a summary article. For more information, you can read a more in-depth reference article: humeral shaft...

Hypoglobus

Hypoglobus refers to the inferior displacement of the globe in the orbit. It may or may not be associated with enophthalmos. Causes include: fracture of the orbital floor (most common) silent sinus syndrome orbital masses orbital foreign bodies thyroid ophthalmopathy

Imaging of gunshot injuries

Gunshot injuries often require imaging assessment, and this evaluation has both clinical relevance (assessment of organ damage, surgical planning, and prognostication), and often also forensic implications. Epidemiology Incidence of gunshot injuries to the head is increasing in some countries,...

Incidental findings on trauma CT

Incidental findings on trauma CT are defined as findings unrelated to the specific mechanism of injury. Epidemiology They are reported to be present in 55-75% of patients, with most being within the abdomen and pelvis 1. As the use of whole body CT for trauma increases, there is an associated ...

Infantile cervical ligament edema

Infantile cervical ligament edema can typically be seen when infants have suffered accidental or abusive head and neck trauma. The finding is best seen on sagittal STIR images. Terminology The posterior ligamentous complex refers to the ligamentum flavum and interspinous ligaments. The anterio...

Inferior shoulder dislocation

An inferior shoulder dislocation is the least common form of shoulder dislocation. The condition is also called luxatio erecta because the arm appears to be permanently held upward, in fixed abduction. The patient will often present with their hand placed on the head or near it. Pathology It i...

Intermediary injury

Intermediary injuries affect the basal ganglia and/or thalami and are associated with diffuse axonal injury and poor prognosis. Pathology They are a shearing injury of the lenticulostriate arteries and result in hemorrhagic contusions, which are often bilateral. Radiographic features CT hy...

Interphalangeal joint dislocation

Interphalangeal joint dislocations are common upper extremity dislocations. Although considered minor injuries by many, they can result in significant disability. Pathology The typical mechanism is a hyperextension injury. The proximal interphalangeal joints are the most commonly involved and...

Investigating fall onto an outstretched hand (summary)

This is a basic article for medical students and other non-radiologists Fall onto an outstretched hand (FOOSH) is a very common presentation across all ages. It occurs following sporting injuries, or simply after a fall. Summary assessment history bimodal age and sex presentation young pa...

Investigating head injury (summary)

This is a basic article for medical students and other non-radiologists Investigating head injury is frequently required because head injury is common: in the US there are 1.3 million traumatic brain injuries per year 1. Causes include falls (children and the elderly), motor vehicle accidents (...

Investigating shoulder injury (summary)

This is a basic article for medical students and other non-radiologists Shoulder injury is a relatively uncommon, but important cause for presentation to the Emergency Department. Pain may be the result of acute or chronic injury. Summary assessment history history of trauma? previous inj...

Isolated free fluid in trauma

Isolated free fluid in trauma may or may not represent a significant injury, and this creates a diagnostic dilemma in determining appropriate treatment for these patients. Epidemiology The presence of isolated free fluid in trauma occurs in 3-5% of blunt trauma patients 1-4. Pathology The c...

Isolated greater trochanteric fracture

Greater trochanteric fractures generally result from forceful muscle contraction of a fixed limb, which usually occurs in those who are young and physically active. It can also be caused by direct trauma. Epidemiology Generally, isolated trochanteric fractures are seen more so in young, active...

Jefferson fracture

Jefferson fracture is the eponymous name given to a burst fracture of the atlas. It was originally described as a four-part fracture with double fractures through the anterior and posterior arches, but three-part and two-part fractures have also been described. Pathology Mechanism A typical m...

Jersey finger

Jersey finger (also called rugby finger or sweater finger) describes a type of injury where there is avulsion of the flexor digitorum profundus (FDP) at the base of the distal phalanx base (volar) 1. Most commonly affects the 4th digit as the FDP insertion into the ring finger is anatomically w...

Johansson classification

The Johansson classification of periprosthetic hip fractures was the first classification system proposed and is the simplest. It is based on the level of the fracture in relation to the prosthesis. type I: fracture proximal to the tip of the prosthesis with the stem still in contact with the m...

Joint effusion

A joint effusion is defined as an increased amount of fluid within the synovial compartment of a joint. There is normally only a small amount of physiological intra-articular fluid. Abnormal fluid accumulation can result from inflammation, infection (i.e. pus) or trauma and may be an exudate, t...

Judet and Letournel classification for acetabular fractures

The Judet and Letournel classification is the most widely used classification system for acetabular fractures. It classifies acetabular fractures into ten major fracture patterns, which consist of five simple patterns and five complex patterns 1,2. Classification The morphology of fracture pa...

Keifhaber-Stern classification of volar plate avulsion injuries of hand

The Keifhaber-Stern classification was proposed originally by Hastings and later modified by Keifhaber and Stern in 1998. This classification, along with the Eaton classification, is the most widely accepted classification at the time of writing (August 2016) for the management of volar plate av...

Knee dislocation

Knee dislocations are rare, but a significant number have a serious associated neurovascular injury. This article discusses tibiofemoral joint dislocation. Please see separate articles for discussion of medial and lateral patellar dislocations. Epidemiology They account for <0.5% of all joint...

Labeled imaging anatomy cases

This article lists a series of labeled imaging anatomy cases by system and modality. Brain CT head: non-contrast axial CT head: non-contrast coronal CT head: non-contrast sagittal CT head: angiogram axial CT head: angiogram coronal CT head: angiogram sagittal CT head: venogram axial CT ...

Large joint dislocation

Large joint dislocations are a frequent presentation to emergency departments. Described in descending order of commonality: shoulder dislocation elbow dislocation posterior dislocation of the hip knee dislocation

Laryngeal trauma

Laryngeal trauma is uncommon in the setting of external blunt or penetrating trauma. The larynx may also be injured internally, for example during endotracheal intubation. Clinical presentation Symptoms include hoarseness, laryngeal pain, dyspnea, and/or dysphagia. Also, stridor, hemoptysis, s...

Lateral humeral condyle fracture

Lateral humeral condyle fractures also referred to simply as lateral condyle fractures (in the appropriate context), are relatively common elbow fractures that predominantly occur in children. They may be subtle but are hugely important to diagnose in a timely manner because if they are missed, ...

Lateral patellar dislocation

Lateral patellar dislocation refers to lateral displacement followed by dislocation of the patella due to disruptive changes to the medial patellar retinaculum. Epidemiology Patellar dislocation accounts for ~3% of all knee injuries and is commonly seen in those individuals who participate in ...

Lateral talar process fracture

Lateral talar process fractures or snowboarder fractures are talus fractures that can mimic a lateral ankle sprain. It may be an isolated fracture or occur as a component of more complex ankle fractures. Mechanism The fracture occurs when the foot is dorsiflexed and inverted, as can happen wit...

Lauge-Hansen classification of ankle injury

The Lauge-Hansen classification system is used for the classification of the ankle injuries based on injury mechanisms which have predictable patterns and imaging findings. Along with the Weber classification, these systems are useful tools for describing and classifying ankle injuries. Classif...

Le Fort fracture classification

Le Fort fractures are fractures of the midface, which collectively involve separation of all or a portion of the midface from the skull base. In order to be separated from the skull base, the pterygoid plates of the sphenoid bone need to be involved as these connect the midface to the sphenoid b...

Levine and Edwards classification

Levine and Edwards classification is used to classify hangman fractures of C2 (also known as traumatic spondylolisthesis of axis). Classification type I: fracture with <3 mm antero-posterior deviation no angular deviation type II: fracture with >3 mm antero-posterior deviation significant a...

Lightbulb sign (shoulder dislocation)

The lightbulb sign refers to the abnormal AP radiograph appearance of the humeral head in posterior shoulder dislocation. When the humerus dislocates it also internally rotates such that the head contour projects like a lightbulb when viewed from the front 1. See also light bulb sign (hepatic...

Lipohemarthrosis

Lipohemarthrosis results from an intra-articular fracture with escape of fat and blood from the bone marrow into the joint, and is most frequently seen in the knee, associated with a tibial plateau fracture or distal femoral fracture; rarely a patellar fracture. They have also been described in ...

Lisfranc injury

Lisfranc injuries, also called Lisfranc fracture-dislocations, are the most common type of dislocation involving the foot and correspond to the dislocation of the articulation of the tarsus with the metatarsal bases. Pathology Anatomy The Lisfranc joint is the articulation of the tarsus with ...

Liver trauma

The liver is one of the most frequently damaged organs in blunt trauma, and liver trauma is associated with a significant mortality rate. Epidemiology In blunt abdominal trauma, the liver is injured ~5% (range 1-10%) of the time 1,3. Clinical presentation Patients can present with right uppe...

Locked facet joint

Locked facet joint is a type of facet joint dislocation that results from jumping of the inferior articular process over the superior articular process of the vertebra below and becomes locked in the position. It can be unilateral or bilateral. Radiographic features Plain radiograph The tip ...

Longitudinal temporal bone fractures

Longitudinal temporal bone fractures are petrous temporal bone fractures that occur parallel to the long axis of the petrous temporal bone. Although more current classifications of the extent of temporal bone fractures focus on the integrity of the otic capsule rather than the fracture orientati...

Longitudinal versus transverse petrous temporal bone fracture

Petrous temporal bone fractures are classically divided into longitudinal, transverse or mixed fracture patterns depending on the direction of fracture plane with respect to the long axis of the petrous temporal bone. Some features may aid in distinguishing them. Longitudinal pe...

Lover's fracture

Lover's fracture, also known as Don Juan fracture, is a type of calcaneal fracture. They are fractures of the calcaneal body and may be intra- or extra-articular. History and etymology The name "lover's fracture" is derived from the fact that a suitor may jump from great heights while trying t...

Lunate dislocation

Lunate dislocations are an uncommon traumatic wrist injury that require prompt management and surgical repair. The lunate is displaced and rotated volarly. The rest of the carpal bones are in a normal anatomic position in relation to the radius. These should not be confused with perilunate disl...

Lung point sign

The lung point sign is a highly specific ultrasound sign of pneumothorax. It involves visualizing the point where the visceral pleura (lung) begins to separate from the parietal pleural (chest wall) at the margin of a pneumothorax. In the absence of pneumothorax, the two pleural layers slide a...

Macklin effect (pulmonary interstitial emphysema and pneumomediastinum)

The Macklin effect describes one of the pathophysiological processes of pneumomediastinum in blunt chest trauma. The Macklin effect accounts for ~40% of severe blunt traumatic pneumomediastinum. Exclusion of tracheobronchial and esophageal causes of pneumomediastinum is mandatory to exclude conc...

Magerl classification of thoracolumbar spinal fractures

The Magerl classification of thoracolumbar spinal fractures is based on the three column concept by Denis, and the McAfee classification. It relies exclusively on CT findings. Classification A: compression injuries A1: impaction fractures A1.1: endplate impaction A1.2: wedge impaction A1.3...

Maisonneuve fracture

Maisonneuve fracture refers to a combination of a fracture of the proximal fibula together with an unstable ankle injury (widening of the ankle mortise on x-ray), often comprising ligamentous injury (distal tibiofibular syndesmosis, deltoid ligament) and/or fracture of the medial malleolus. It i...

Mallet finger

Mallet finger refers to injuries of the extensor mechanism of the finger at the level of the distal interphalangeal joint (DIP). They are the most prevalent finger tendon injury in sport. They may represent an isolated tendinous injury or occur in combination with an avulsion fracture of the bas...

Malunited fractures - most common (mnemonic)

A useful mnemonic to remember the most common malunited fractures is: CSI - Miami Mnemonic C: Colles fracture S: scaphoid fracture I: intertrochanteric femoral neck fracture Miami: malunion

Mandibular fracture

Mandibular fractures are relatively common especially among young men. Although traditionally the mandible and base of skull are thought to form a complete bony ring, interrupted only by the TMJs. This should mean that the mandible should fracture in two places (akin to the bony pelvis) making s...

Marshall classification of traumatic brain injury

The Marshall classification of traumatic brain injury is a CT scan derived metric using only a few features and has been shown to predict outcome in patients with traumatic brain injury. This system was first published in 1992 1 building on findings from a large cohort of head injury cases des...

Mayfield classification of carpal instability (perilunate instability)

Mayfield classification of carpal instability, also known as perilunate instability classification (carpal dislocations), describes carpal ligament injuries. Instability has been divided into four stages 1-2: stage I: scapholunate dissociation (rotatory subluxation of the scaphoid) disruptio...

Mayo classification of scaphoid fractures

Mayo classification of scaphoid fractures divides them into three types according to the anatomic location of the fracture line: middle (70%) distal (20%) proximal (10%) Fractures of the distal third are further divided into distal articular surface and distal tubercle fractures: distal tub...

McAfee classification of thoracolumbar spinal fractures

McAfee classification of acute traumatic spinal injuries is one of a number of thoracolumbar spinal fracture classification systems and based on the three-column concept of the spine (of Denis). It requires CT for an accurate assessment. Usage The McAfee classification uses terminology that is...

McGrigor-Campbell lines

McGrigor-Campbell lines are imaginary lines traced across the face on an occipitomental (Waters) view skull radiograph to assess for fractures of the middle third (especially) of the face3: first line is traced from one zygomaticofrontal suture to another, across the superior edge of the orbits...

Mellado-Bencardino classification of Morel-Lavallée lesions

The Mellado-Bencardino classification of Morel-Lavallée lesions is based on shape, signal and enhancement characteristics, and the presence or absence of a capsule 1: type I: laminar-shaped and seroma-like with increased T2 signal type II: oval-shape that resembles a subacute hematoma with in...

Meniscal root tear

Meniscal root tears are a type of meniscal tear in the knee where the tear extends to either the anterior or posterior meniscal root attachment to the central tibial plateau. They often tend to be radial tears extending into the meniscal root. Epidemiology According to one source, they are th...

Metacarpal fracture

Metacarpal fractures are common. Fractures of the metacarpal bones account for 10% of all fractures and 40% of all hand fractures. The lifetime incidence of a metacarpal fracture is 2.5%. Terminology Specific names are given to fractures of the base of the first metacarpal (see: fractures of t...

Metaphyseal fracture

Metaphyseal fractures are fractures that involve the metaphysis of tubular bones. They may occur in pediatric or adult patients. Examples of metaphyseal fractures: adults surgical neck of humerus fracture distal radial fracture transtrochanteric fracture children distal radial buckle frac...

Midcarpal dislocation

Midcarpal (central carpal) dislocation describes an injury where there is dislocation of the capitate from the lunate, and subluxation of the lunate from the radius. This term is somewhat confusing because some authors use "midcarpal dislocation" to refer generally to perilunate and lunate dislo...

Middle phalanx fracture

Middle phalanx fractures are the least common of the phalanx fractures. Radiographic features These fractures are generally well visualized on plain radiographs. Ultrasonography can be used in unclear cases. Treatment and prognosis Non-displaced fractures can be treated conservatively with a...

Milch classification of lateral humeral condyle fractures

The Milch classification is one of the classification systems that can be used for lateral humeral condyle fractures and splits these fractures into two groups depending on their relationship with the trochlear groove: type I: fracture passes lateral to the trochlear groove type II: fracture p...

Minimal aortic injury

Minimal aortic injuries are traumatic aortic lesions that usually involve the intima and are recognized more frequently due to the use of high-resolution imaging. Epidemiology Minimal aortic injuries account for 10-28% of all blunt traumatic aortic injuries 1,6,7. The proportion of this type o...

Mixed temporal bone fractures

Mixed temporal bone fractures are a combination of longitudinal and transverse fracture types, and are probably the most common type. They frequently involve the otic capsule, and are associated with both conductive and sensorineural hearing loss.

Modified Memphis criteria for blunt cerebrovascular injury

The modified Memphis criteria are a set of screening criteria for blunt cerebrovascular injury (BCVI) in trauma. The presence of one or more of these criteria makes necessary a complementary CTA or DSA study to exclude a BCVI. The screening protocol criteria for BCVI are: base of skull fractur...

Molar tooth sign (disambiguation)

The molar tooth sign may refer to: molar tooth sign (CNS) molar tooth sign (abdomen)

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