Biomedical subjects
Publications and source records attributed to H O Riddervold.
This article reviews easily missed fractures. Spinal fractures predominate in the discussion, but fractures of the chest/upper extremity and pelvis/lower extremity also are included. Ample illustrative radiographs are provided.
Dislocations of the sternoclavicular joint are relatively uncommon, but diagnosis and management can be difficult, with posterior dislocations being potentially very serious. The anatomy of the joint, and the mechanisms of dislocation, are described. The radiologic diagnosis is discussed and three case reports are presented to illustrate varieties of dislocation. Although computed tomography is the ideal method of demonstrating the sternoclavicular joint, some specialized plain film projections are often useful. These should be more widely known and are described and illustrated. Treatment is briefly discussed.
Posterior dislocations of the sternoclavicular joint are uncommon, but are potentially quite serious. Radiologic diagnosis and management are frequently difficult. The specialized projections available are not widely known, and the role of plain films is poorly understood. The incidence, pathomechanics, and clinical manifestations of such dislocations are presented and the radiologic diagnosis is discussed.
We present four cases of carpal bone fractures which were not recognized on standard anteroposterior (AP) and lateral views of the wrist. When there is clinical suspicion of fractures of the hook of the hamate, pisiform, or trapezium, either because of the mechanism of injury or clinical presentation, a carpal tunnel view of the wrist is often helpful to disclose previously unrecognized fractures.
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A patient with direct trauma to the orbit was found to have an ocular air-fluid level, apparently the first such case to be reported.
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Presented is a case demonstrating slipped capital femoral and capital humeral epiphyses. The physician should keep in mind not only that slipped capital femoral epiphyses may indicate renal osteodystrophy but that epiphysiolysis elsewhere is increasingly a recognized finding in this entity.
Weight-bearing views in suspected acromio-clavicular separation may be misleading if there is extensive spasm of the deltoid and trapezius muscles. The effect of this spasm may be lessened by strapping the weights to the wrist rather than having them hand-held. However, if there is strong clinical suspicion of an acromio-clavicular separation and the stress films, however taken, fail to reveal an upward displacement of the clavicle or widening of the joint space, the study should be repeated after infiltration of the acromio-clavicular joint with local anesthetic.
The value of the anterior lordotic projection in visualizing fractures of the medial end of the clavicle is demonstrated in the following case report.
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Pseudosubluxation or anterior slippage of the axis on C-3 is a well recognized physiologic phenomenon in children. Because of a downward shifting of the apex of flexion of the cervical spine that occurs at about age 10, this physiologic offset of C-2 has been thought unlikely to occur in older individuals. However, a review of a series of flexion and extension cervical spine films showed six such cases in the 14- to 21-year age range.
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Two cases of acute plastic bowing fractures of the fibula are described. A brief description of the mechanism of bone deformation under stress and the pathological cortical microfractures involved in bowing fractures is given.
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