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Trauma Upperlimb Juring

This document provides an overview of common upper limb injuries visible on x-rays. It begins with an introduction and outlines that fractures have characteristic appearances according to the injured region and mechanism of injury. Examples are then shown of typical fractures and normal appearances of the clavicle, scapula, and humerus. Key learning points are emphasized for each bone region discussed. The tutorial concludes by restating that all available images should be considered together with clinical findings for accurate interpretation.

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meita wulandari
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104 views7 pages

Trauma Upperlimb Juring

This document provides an overview of common upper limb injuries visible on x-rays. It begins with an introduction and outlines that fractures have characteristic appearances according to the injured region and mechanism of injury. Examples are then shown of typical fractures and normal appearances of the clavicle, scapula, and humerus. Key learning points are emphasized for each bone region discussed. The tutorial concludes by restating that all available images should be considered together with clinical findings for accurate interpretation.

Uploaded by

meita wulandari
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOC, PDF, TXT or read online on Scribd
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TRAUMA X-RAY - UPPER LIMB

I. Tutorial introduction

Tutorial key points


 Many injuries to the upper limb visible on X-ray have characteristic
appearances according to the region injured and mechanism of injury
 All images available should be viewed with reference to clinical
findings
This tutorial discusses the X-ray appearances of upper limb trauma.
Examples of common injuries seen on X-ray are shown, with normal images for
comparison.
Before starting this tutorial you should be aware of principles as discussed
in the 'General Principles' and 'Introduction to Trauma X-ray' tutorials.
This tutorial is suitable for clinicians working in the emergency department
setting who require a knowledge of trauma X-ray interpretation.

Course assessment
A certificated course completion assessment is available which is based on
the material in this tutorial and the related sections.
All our online course completion certificates are CPD/CME accredited by
the Royal College of Radiologists, London, UK.
II. Clavicle
Key points
 Clavicle fractures result in inferior displacement of the distal
component

The clavicle is the most proximal bone of the upper limb, and provides
leverage and support for the shoulder girdle structures.

Clavicle - Normal appearances


 Cortex intact

Clavicle fractures
A fracture of the clavicle characteristically leads to inferior displacement
of the distal component - weighed down by the whole arm.

Clavicle - Fracture
 Transverse/oblique mid shaft fracture
 Inferior displacement of the distal clavicle
XI. Tutorial Conclusion

Key points
 Many injuries to the upper limb visible on X-ray have characteristic
appearances according to the region injured and mechanism of injury
 All images available should be viewed with reference to clinical
findingsfindings
This tutorial has highlighted many of the important bone and joint injuries
commonly encountered in the upper limb.
The general principles of viewing musculoskeletal X-rays must be adhered
to and the X-ray must be considered in the light of clinical findings.

Course assessment
A certificated course completion assessment is available which is based on
the material in this tutorial and the related sections.
All our online course completion certificates are CPD/CME accredited by
the Royal College of Radiologists, London, UK.
Scapula
Key points
 Check the scapula carefully in the context of trauma

Scapula fractures are relatively uncommon. Careful attention should be


paid to the standard shoulder views as scapula injuries are often found when not
suspected clinically. Subtle fractures are easily missed if care is not taken.

Scapula - Normal
 Anatomical parts of the scapula include - body, neck, glenoid,
coracoid, spine and acromion
 The scapula body has lateral, medial and superior borders
Scapula fracture
 Displaced fracture of the scapula lateral border
 Fracture line passing through the scapula body

'Bony Bankart' fracture


There is often injury to the glenoid cartilage as a result of shoulder
dislocation. This is known as a 'Bankart' lesion and is not visible on X-rays.
Occasionally there is visible injury to the bony glenoid - often called a 'bony
Bankart' lesion.
This fracture is most often seen on an X-ray taken following reduction of a
glenohumeral joint dislocation.

Glenoid fracture - (Bony Bankart)


 A bone fragment is seen lying adjacent to the incomplete rim of the
glenoid

Clinical information
 The X-ray had been acquired following reduction of an anterior
shoulder dislocation
Humerus
Key points
 The surgical neck is the commonest site of humerus fracture

Fractures of the humerus are common at the surgical neck. A fracture line
may extend into the humerus head with separation of the tubercles.
Fractures of the humerus shaft are not uncommonly due to a pathological
lesion. Distal fractures are considered with the elbow.

Humerus fracture - Head and neck


 Transverse fractures of the surgical neck (red line)
 Fracture line (yellow) causing separation of the greater tubercle
Humerus fracture - Shaft
 Poorly defined lytic lesion of the humerus shaft
 Fracture with varus angulation (not clearly visible on the lateral
image)
Clinical information
 Trivial trauma to upper arm
 Known history of multiple myeloma
Diagnosis
 Pathological fracture of humeral shaft

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