|
|
Re: Those darn monkey bars
|
Logged in as: Guest
|
|
Users viewing this topic:
none
|
|
Login  | |
|
Re: Those darn monkey bars - April 1, 2005 2:37:00 AM
|
|
|
Alex Brenner PT MPT OCS
Posts: 1057
Joined: February 29, 2004
From: Kentucky
Status: offline
|
JMA,
I believe the pisiform can displace although I feel it is not in this case, neither did the radiologist. This particular view just makes it appear like it is. This patient had no pain over the medial hand or over the pisiform. Good eye though.
_____________________________
Alex Brenner, PT, MPT, OCS
|
|
|
|
|
Re: Those darn monkey bars - April 1, 2005 3:13:00 AM
|
|
|
Jeep
Posts: 353
Joined: March 28, 2003
From: USA
Status: offline
|
The ossification center of the Pisiform appears @ 8 yrs. It is not present at birth, and the above films are not representative of the "adult" pisiform.
SO------ IMO: this pisiform represents the immature pisiform and normal presentation of the pisiform of a person of this age.
disclaimer: I am not a radiologist,(medical or chiropractic) and this represents my opinion only (based upon my experience/education only), which could be wrong!! LOL!!!
|
|
|
|
|
Re: Those darn monkey bars - April 1, 2005 3:41:00 AM
|
|
|
jma
Posts: 2312
Joined: August 24, 2000
From: NY
Status: offline
|
Thanks for the info. Keep the images rolling in.
|
|
|
|
|
Re: Those darn monkey bars - April 3, 2005 3:25:00 AM
|
|
|
Andrew M. Ball PT PhD
Posts: 855
Joined: July 28, 2002
From: Charlotte, NC
Status: offline
|
We should also keep in mind that in kids this young (under 14 or so), observation of an elbow fracture is particularly tough (esp. in the acute phase). On lateral view, we can drop a line down the anterior aspect of the humerus into the capitulum, and see where it hits, but sometimes that comes out looking quite normal in the acute phase. We should therefore be looking for an anterior fat pad sign (she doesn't have one).
Drew
_____________________________
Dr. Andrew M. Ball, PT, DPT, Ph.D.
|
|
|
|
|
Re: Those darn monkey bars - April 4, 2005 1:34:00 PM
|
|
|
chiroortho
Posts: 655
Joined: February 18, 2004
Status: offline
|
For folks that aren't familiar with peds radiography, it is a very common and understandable mistake to interpret unfused epiphyses as fractures. Nobody should feel bad about that, because even the fancypants pediatric orthopedists have difficulty ascertaining certain Salter-Harris fx's. My own little girl (3 years old) managed to get herself a buckle fx of the distal tibia during a gymnastics class, and we took her to the peds who sent us straight over to the peds ortho, very nice guy from South Africa (my favorite accent). Anyway, he didn't mention S-H issues, so I asked. He throws the films back up and says something like 'Yeah it's hard to tell but I think she's okay.' There was no clear S-H thanks be to God, but he appeared to be a little surprised about it when I politely asked.
_____________________________
Greg Priest, DC, DABCO
|
|
|
|
|
Re: Those darn monkey bars - April 5, 2005 1:55:00 AM
|
|
|
JLS_PT_OCS
Posts: 1684
Joined: January 30, 2005
From: USA
Status: offline
|
Good point, Greg.
And I have more cases of people calling epiphyses fractures (especially in the shoulder of some young 17 y/o soldiers) than I can count on one hand.
Some of the calls are really tough.
That's why I'm glad radiologists are around...
J
_____________________________
Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
|
|
|
|
|
Re: Those darn monkey bars - April 5, 2005 7:07:00 AM
|
|
|
chiroortho
Posts: 655
Joined: February 18, 2004
Status: offline
|
That's a very good point. In the military you've got some soldiers/sailors/airmen/marines that aren't fully skeletally mature. This can confound the radiologist who is trying to determine whether or not the paratrooper has a S-H fx of the distal radius or not.
Hadn't thought about that.
_____________________________
Greg Priest, DC, DABCO
|
|
|
|
 New Messages |
 No New Messages |
 Hot Topic w/ New Messages |
 Hot Topic w/o New Messages |
 Locked w/ New Messages |
 Locked w/o New Messages |
|
 Post New Thread
Reply to Message
Post New Poll
Submit Vote
Delete My Own Post
Delete My Own Thread
Rate Posts |
|
0.063
|
Printable Version
