Find the fracture... (Full Version)

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Alex Brenner PT MPT OCS -> Find the fracture... (January 11, 2006 9:56:00 AM)

Subtle fracture, one view, small image, crappy computer screen. Lets see how good you are. :)

[IMG][image]http://img.photobucket.com/albums/v85/brennerak/jc.jpg[/image][/IMG]




SJBird55 -> Re: Find the fracture... (January 11, 2006 12:07:00 PM)

My eyes are initially drawn toward the hamate where it borders the lunate. Maybe at the distal kind of lateral navicular? I can't really tell though.

I've never really understood how radiologists can easily look at radiographs and read them without a decent chunk of history - you know, like in this case... fell on outstretched hand or hit with blunt object. LOL




Sean Weatherston -> Re: Find the fracture... (January 11, 2006 12:33:00 PM)

Looks like there's a little somethin' somethin' at the medial hamate.

BTW, what's the brighter white area also on the hamate? Assuming it's the hook of the hamate, but someone please correct me if I'm wrong...

Sean




MPT -> Re: Find the fracture... (January 11, 2006 7:33:00 PM)

The 1st proximal phalynx looks like it has a fx right at the joint line, on the ulnar side.




jma -> Re: Find the fracture... (January 11, 2006 7:52:00 PM)

I agree something like a fx at the medial hamate. Im also curious about the ulnar side of the 1st proximal phalanx.




FLAOrthoPT -> Re: Find the fracture... (January 11, 2006 9:20:00 PM)

ditto, would have to say this would not be the view to look at the hammate, but that proximal side does look like small fx., was looking for somse soft tissue swelling to give this away, but cannot find it, let me ask you this though. Seeing the Fx or not seeing the Fx, would your treatment differ?




Alex Brenner PT MPT OCS -> Re: Find the fracture... (January 17, 2006 6:36:00 AM)

[IMG][image]http://img.photobucket.com/albums/v85/brennerak/jc2.jpg[/image][/IMG]




SJBird55 -> Re: Find the fracture... (January 17, 2006 6:46:00 AM)

The perfect example of why one should always have 2 views. Is that the same person? LOL




connie.pt -> Re: Find the fracture... (January 18, 2006 9:56:00 AM)

Ha Ha! you got us, Alex!

...so there isn't a fx of the hamate, huh?




ehanso -> Re: Find the fracture... (January 18, 2006 1:16:00 PM)

OK I'll take a stab at it. Distal - Medial aspect of the proximal 5th phalange. ???




SJBird55 -> Re: Find the fracture... (January 18, 2006 1:20:00 PM)

Falls, isn't it the infamous middle finger?




ehanso -> Re: Find the fracture... (January 19, 2006 8:26:00 AM)

I was looking at the first view. But is IceBox Days this week so maybe I had a brain freeze.




Sebastian Asselbergs -> Re: Find the fracture... (January 19, 2006 4:01:00 PM)

seriously, I think I see a fracture at the anterior base of the middle phalanx of the third finger (even in the first view...)- appropriately positioned for our drivers here...




Sebastian Asselbergs -> Re: Find the fracture... (January 23, 2006 11:31:00 AM)

...still seeing it....Do I need to change my meds?




jma -> Re: Find the fracture... (January 23, 2006 5:41:00 PM)

I see it as well. Were we close or far off Alex?




Alex Brenner PT MPT OCS -> Re: Find the fracture... (January 24, 2006 1:28:00 AM)

There is a nondisplaced, incomplete, oblique fracture through the palmar aspect of the base of the third middle phalanx with mild adjacent soft tissue swelling. No other osseous or soft tissue abnormalities are noted.


[IMG][image]http://img.photobucket.com/albums/v85/brennerak/jc3.jpg[/image][/IMG]




Sebastian Asselbergs -> Re: Find the fracture... (January 24, 2006 5:19:00 AM)

whoopeee.




jma -> Re: Find the fracture... (January 24, 2006 5:58:00 PM)

Thanks for the clarification Alex. Keep them coming!




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