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Extradural hematoma vs subdural hematoma

Differentiating extradural (EDH) from subdural (SDH) hemorrhage in the head is usually straightforward, but occasionally it can be challenging. SDHs are more common and there are a few distinguishing features which are usually reliable. Pathology History and mechanism of injury Extradural hem...

Extradural hemorrhage

Extradural hematoma (EDH), also known as an epidural hematoma, is a collection of blood that forms between the inner surface of the skull and outer layer of the dura, which is called the endosteal layer. They are usually associated with a history of head trauma and frequently associated skull fr...

Extrapleural hematoma

Extrapleural hematomas are uncommon and usually seen in the context of rib fracture, subclavian venous catheter traumatic insertion, and blunt chest injury. Pathology Extrapleural hematomas result from the accumulation of blood in the extrapleural space where the overlying extrapleural fat is ...

Facet dislocation

Facet dislocation refers to anterior displacement of one vertebral body on another. Without a fracture, the only way anterior displacement can occur is by dislocation of the facets. Facet dislocation can occur to varying degrees: subluxed facets perched facets locked facets The injury usua...

Facial fractures

Facial fractures are commonly caused by blunt or penetrating trauma at moderate or high levels of force. Such injuries may be sustained during a fall, physical assault, motor vehicle collision, or gunshot wound. The facial bones are thin and relatively fragile making them susceptible to injury. ...

Fallen lung sign

The fallen lung sign (also known as CT fallen lung sign) describes the appearance of collapsed lung away from the mediastinum encountered with tracheobronchial injury (in particular those >2 cm away from the carina). It is helpful to look for this rare but specific sign, in cases of unexplained ...

Fall onto an outstretched hand

Fall onto an outstretched hand (FOOSH) is a common mechanism for traumatic disruption of the osseous and ligamentous structures of the wrist, forearm and elbow. Some commonly recognized patterns of injury include; distal radial fractures Colles fracture Smith fracture Barton fracture Chauff...

Fatigue fracture

Fatigue fractures (also known as overuse fractures) are a type of stress fracture due to abnormal stresses on normal bone. They should not be confused with an insufficiency fracture, which occurs due to normal stresses on abnormal bone. Plain radiographs typically demonstrate a linear sclerotic ...

Femoral artery pseudoaneurysm

Femoral artery pseudoaneurysms are usually iatrogenic, as the femoral artery is the vessel of choice for most endovascular arterial interventions. Pathology Etiology iatrogenic anticoagulation therapy inadequate compression following femoral arterial puncture for endovascular intervention ...

Finger pulley injury

Finger pulley injuries can occur at any one of the five flexor tendon pulleys of the fingers, but most commonly affects the A2 pulley. Clinical presentation These are overwhelmingly the result of a discrete trauma occurring with the hand in a finger grip position. They are most frequently see...

Flail chest

Flail chest or flail thoracic segment occurs when three or more contiguous ribs are fractured in two or more places. Clinically, a segment of only one or two ribs can act as a flail segment, hence there is some controversy between the clinical and radiological definitions. Clinical presentation...

Fleck sign (disambiguation)

The radiographic fleck sign refers to an avulsion fracture in the lower limb at either of two sites: fleck sign (ankle) due to superior peroneal retinaculum injury fleck sign (foot) due to Lisfranc injury

Flexion supracondylar fracture

Flexion supracondylar humeral fractures account for only 2-4% of all supracondylar fractures 1. Epidemiology Unlike the much more common extension supracondylar fracture which are seen in children, flexion fractures are seen in older (adult) patients. Pathology They are usually the result of...

Flexion teardrop fracture

Flexion teardrop fractures represent a fracture pattern occurring in severe axial/flexion injury of the cervical spine. They are important to recognize because they indicate extensive underlying ligamentous injury and spinal instability. Associated spinal cord injury is common, especially anteri...

Focused Assessment with Sonography for Trauma (FAST) scan

Focused Assessment with Sonography for Trauma (FAST) scan is a point-of-care ultrasound examination performed at the time of presentation of a trauma patient. It is invariably performed by a clinician, who should be formally trained, and is considered as an 'extension' of the trauma clinical a...

Foot (weightbearing dorsoplantar view)

The weightbearing dorsoplantar foot radiograph is a specialized projection of the foot. Nonweightbearing views (e.g. DP foot) are inadequate for the assessment of alignment because the bones of the feet are not in a functional position. Indications This view is key to the assessment of foot a...

Forearm fracture

Forearm fractures are a group of fractures that occur in the forearm following trauma. The radius and ulna are bound together at the proximal and distal radioulnar joints and act as a ring. Like elsewhere in the body, it is difficult to only fracture one bone if there is a bony ring. If the radi...

Forearm fracture (summary)

This is a basic article for medical students and other non-radiologists Forearm fractures are a group of fractures that occur in the forearm following trauma. The radius and ulna are bound together at the proximal and distal radioulnar joints and act as a ring. Like elsewhere in the body, it is...

Forearm (horizontal beam lateral view)

The horizontal beam lateral forearm view is one of two modified trauma projections in the forearm series, examining the radius and ulna. Indications This view is ideal for patients who are unable to move their arm as per the standard forearm positioning technique but require assessment of sus...

Forearm (PA view)

The posteroanterior forearm view is one of two modified trauma projections in the forearm series, examining the radius and ulna. Indications This view is ideal for patients who are unable to move their arm as per the standard forearm positioning technique but require assessment of suspected r...

Fracture-a-la-signature (skull fracture)

Fracture-a-la-signature (or signature fracture) is another term used to described a depressed skull fracture. Fracture-a-la-signature derives its name from forensic medicine because the size and shape of a depressed skull fracture may give information on the type of weapon used. It can be a si...

Fracture article structure

Articles describing fractures require a different set of subheadings from a 'standard' article, as the usual epidemiology, clinical presentation, pathology etc., may not be relevant. Example article: clavicular fractures =======================================================================...

Fracture complications (summary)

This is a basic article for medical students and other non-radiologists Assessment of fracture complications is key to accurate assessment of a fracture. It is vital to assess for these when describing a fracture. Reference article This is a summary article. There is no accompanying reference...

Fracture description (summary approach)

This is a basic article for medical students and other non-radiologists Fracture description allows an individual to accurately determine fracture type and communicate important information to colleagues without the use of the radiograph. Practicing fracture description is important and using a...

Fracture-dislocations of the radius and ulna

Fracture-dislocations of the radius and ulna illustrate the importance of including the joint above and below the site of injury on radiographic assessment. Most forearm fractures (60%) include fracture of the distal radius as well as an ulnar fracture. In some cases, there is associated disloc...

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's thumb

Gamekeeper's thumb, also known as skier's thumb or break-dancer's thumb is avulsion or rupture of the ulnar collateral ligament (UCL) of the first metacarpophalangeal joint. Terminology Skier's thumb refers to acute injury due to trauma, from hyperabduction of the thumb as it is caught by the ...

Gamma nail

The gamma nail or trochanteric nail is an osteosynthetic implant designed to treat proximal femoral fractures in the trochanter area with a closed intramedullary fixation method. The gamma nail consists of a funnel-shaped intramedullary nail with slight bending to reflect proximal femoral diaph...

Gartland classification of supracondylar humeral fractures

The Gartland classification of supracondylar fractures of the humerus is based on the degree and direction of displacement, and the presence of intact cortex. It applies to extension supracondylar fractures rather than the rare flexion supracondylar fracture. Classification type I: undisplaced...

Gehweiler classification of atlas fractures

The Gehweiler classification of atlas fractures described 5 types of fractures of the atlas. In addition, Dickman classified injuries of the transverse atlantal ligament (transverse band of the cruciform ligament) which has been incorporated into this classification system. type 1: fractures of...

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 second arc: tra...

Glass foreign body

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 blunt trauma, ruptures are most common at the insertions of the intraocular muscl...

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 (alternative plural: hematomata) 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 an...

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...

Hallux sesamoid fracture

Hallux sesamoid fractures are the commonest foot sesamoid fractures, with the medial sesamoid fractured more frequently than the lateral one 1. These hallucal sesamoids are also vulnerable to weight-bearing stress injury 2. Radiographic features A sharp fracture line is seen separating irregul...

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...

Hand series (pediatric)

The hand series for pediatrics often consist of a posteroanterior and lateral view only in order to minimize radiation dose to the patient. Depending on the department and clinical indication, an additional oblique view may also be done. Indications trauma with suspected fracture suspected di...

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 defect

A Hill-Sachs defect is a posterolateral humeral head depression fracture, resulting from the impaction with the anterior glenoid rim, therefore indicative of an anterior glenohumeral dislocation. It is often associated with a Bankart lesion of the glenoid. Terminology A Hill-Sachs defect is th...

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...

Hyperextension cervical injuries

Hyperextension cervical injuries are not uncommon and extremely serious: avulsion fractures of the anterior arch of the atlas (C1) vertical fracture through the posterior arch of the atlas as a result of compression fractures of the dens of C2 hangman fracture of C2 hyperextension teardrop ...

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

Ice cream cone sign (disambiguation)

The ice cream cone sign may refer to: ice cream cone sign (middle ear ossicles) ice cream cone sign (vestibular schwannoma)

Ice cream cone sign (middle ear ossicles)

The ice cream cone sign describes the normal appearance of the middle ear ossicles on axial CT scan. The ball of the ice cream is formed by the head of the malleus and cone is formed by the body of the incus, with the tapering conical point formed by the short process pointing towards the aditus...

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 ...

Incomplete fracture

Incomplete fractures are a heterogeneous group of fractures that predominantly occur in the long bones of pediatric patients. Rang 1 describes a continuum of fractures that occur with increasing longitudinal force applied along the length of the bone. At the point where force exceeds the structu...

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 or intermediary contusions affect the basal ganglia and/or thalami and are uncommon manifestations of diffuse axonal injury associated with a poor prognosis. Terminology The term is not widely used and they are known as intermediary because they occur between coup and con...

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...

Intra-articular fragments

Intra-articular fragments are a form of intra-articular bodies that result from traumatic injuries such as fractures, dislocations and chondral injury. Clinical presentation Symptoms are variable and also depend on the underlying cause and extent of the injury, but usual complaints are pain, l...

Intramedullary nailing

Intramedullary nailing is an internal fixation technique mainly used for the surgical management of long bone diaphyseal fractures and since more recently also in metaphyseal and periarticular fractures. History and etymology Bircher reported an intramedullary fixation with ivory pegs in 1886,...

Intramuscular degloving injury

An intramuscular degloving injury is a term referred to a circumferential intermuscular dissociation of inner and outer muscular components with or without retraction. It has been described in the rectus femoris muscle. Terminology An intramuscular degloving injury has been also described as b...

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) from the volar base of the distal phalanx base 1. It classically occurs during certain sports resulting from sudden hyperextension of actively fle...

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 the tibiofemoral joint dislocation. Please see separate articles for discussion of medial and lateral patellar dislocations. Epidemiology They account for <0.5% of all j...

Knee (horizontal beam lateral view)

The horizontal beam lateral view (cross-table lateral) is an orthogonal view of the AP view of the knee requiring little to no patient movement and is hence the lateral projection of choice for acute knee injuries. Indications This view is the ideal projection to assess for lipohemarthrosis as...

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...

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