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upper quarter clin med
Terms in this set (98)
routine view for scapula?
Oblique IR, Oblique ER, AP, lateral
routine view for elbow
Green stick fracture
incomplete fracture due to flexibility of young bones
ulnar deviation view
optional wrist radiograph view
AP ER and AP IR
goal get a better look at the shoulder
routine view of shoulder and the goal?
shoulder AP ER x ray
shoulder AP IR x ray - diff view of coracoid
what view is this and what does it show us?
SEPERATION = seperated shoulder = talking about AC
AC joint is a?
AP bilateral with weights and AP bilateral without weights
routine views of AC joint
DJD, OA, AC joint arthritis
if it is atraumatic what individuals would have pain or dysfunction with AC joint?
What group will have early arthritis at AC joint
MOA- falling directly on shoulder
how would someone have a traumatic AC joint pathology
AC Joint (with/without weights)
if there is pain over scapula think?
AP view of scapula
AP view of scapula
lateral view of scapula (patient is laying with x ray going into armpit and hand over head sidelying)
axillary view, scapular y view
additional views of scapula
axillary view of scapula = additional view
scapular y view = additional view
relationship of humeral head to glenoid cavity and shows part of scapula projected to rib cage
what does scapular y view show us
MRI, CT, radiograph
for shoulder what imaging is recommended
most common is anterior goes anterior and inferior - anterior dislocation= abduction and external rotation (ex go for rebound and get pulled back)
What is MOA of shoulder for the most common shoulder dislocation?
UFC fighter punching and shoulder dislocating posterior
what is MOA for posterior shoulder dislocation
stress fracture even a CT could miss the stress fracture/ stress reaction
MRI in shoulder is best for?
sensitive but not specific - good for hot spots but we do not know what it is
a bone scan is?
stress fracture and soft tissue
MRI is best for?
axial, sagittal, coronal oblique
shoulder CT projections?
shoulder axial CT scan
shoulder sagittal CT
picks up bone, soft tissue and mass that could be a tumor
benefit of CT
coronal oblique CT shoulder
axial, sagittal oblique, coronal oblique, arthrogram
shoulder MRI projections
MRI shoulder axial projection
T2- white joint space with synovial fluid
MRI sagittal oblique shoulder
T1- CSF= black
MRI coronal oblique shoulder
what adds soft tissue to hold head of humerus
arthrogram MRI shoulder
f- anterior labrum
what is this and what is F
for trauma- biggest thing= listen to patients history
what is the most important thing for a shoulder injury?
glenohumeral fracture of surgical neck
glenohumeral fracture of anatomical neck
where do compression fractures happen at shoulder?
shoulder dislocations first need to be seen by
Anterior Glenohumeral Dislocation
injury of anterior (inferior ) glenoid labrum of the shoulder due to anterior dislocation
inferior portion of the capsule and ant inferior of glenoid
what is bankart leison
think of wearing a tight shirt, practice holding shirt tight
fracture of anterior (inferior) glenoid of the shoulder due to anterior shoulder dislocation
Traumatic, unilateral, bankart surgery
acronym for bankart fracture/ boney lesion that needs to be seen by orthopod/ surgeon
atraumatic, multidirectional, bilateral, rehab, inferior capsular shift= surgical procedure
usually in swimmers
acronym for someone who has lax joints (typically found in who?)
hill sachs leison
defect in posterior superior humeral head like dent
hill sachs and bankart lesion
posterior GH dislocation
displaced clavicle fracture
type 1- disruption of AC part
type 2- complete disruption, full AC and partial CC
type 3- disruption of both, full AC and full CC
3 types of AC joint seperation
amount of disability
look at yourself in mirror and ask if rehab could make this better? could you manage case from start to finish?
or if there is no correlation between tissue damage and pain
for rotator cuff what questions do you need to ask to refer to doc for musculoskeletal condition?
do this when they arent improving only getting back to 80%
what if you need to send a patient to surgeon ASAP for rotator cuff tear?
best imaging for rotator cuf tear
rotator cuff tear
rotator cuff tear
axial magnetic resonance arthrography = best for labral tear
positive sail sign on elbow = positive radial head fracture
what do you look for on lateral elbow x ray
oblique IR elbow
oblique ER elbow
anatomic location of olecranon relative to humerus
posterior dislocation of elbow is named by?
fall on outstretched hand
FOOSH+ immediate onset of pain= radial head fracture
MOST COMMON FRACTURE IN ELBOW
what is FOOSH and what is usually fractured
radial head fracture in elbow
redult= bone effusion (bone being eaten away)
AP view of forearm
lateral view of forearm
nightstick fracture- midportion of ulna- think defensive
monteggia- fracture proximal ulna with dislocation of radial head THINK FOOSH
Galeazzi fracture- fracture of distal radius with dislocation of ulnar head THINK FOOSH
3 classic fractures of forearm?
greenstick fracture - incomplete fracture of forearm in young bones
PA, lateral, oblique
routine views of the wrist
PA, lateral, oblique
routine views of the hand
hand oblique (think palmar part of hand on wedge)
ulnar deviation, scaphoid view - avascular necrosis- if someone has a lot of tenderness in anatomical snuff box its a fracture of scaphoid no matter what imaging says cant rule out scaphoid fracture
optional wrist view and why is it so important?
ulnar, radial deviation and carpal tunnel view
optional wrist views?
1st scaphoid frcature
what are the common fractures in the carpals?
what is most accurate imaging for scaphoid fracture?
proximal pole because it is furthest away from blood supple
What part of scaphoid is most at risk for AVN?
high incidence approx 30% AVN
fractures in proximal 1/3 of scaphoid have?
most frequent farcture side with moderate risk of AVN
wrist fractures in middle 1-3 of scaphoid are?
rarely complicated by AVN
fracture of distal 1/3 pole of scaphoid
colles fracture (distal radius fracture) - distal fragment has dorsal angulation when you fall faced forward catching yourself with palm
smith fracture (distal radius fracture) drunk fall - distal fragment has palmar angulation
boxers fracture- fracture of 5th metacarpal
- rupture of ulnar collateral ligament of MCP of thumb
- MRI- best to evaluate
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