Dr.

Tasir Ahmed
Dr. Tasir Ahmed
RADIOLOGY OF
BONES

Dr. Tasir Ahmed

RADIOLOGY OF BONES

BONE
TRAUMA
Dr. Tasir Ahmed
BONES:
• Bone is specialized form of connective
tissue.
• Extra cellular components are
mineralized.
• This confers marked rigidity & strength.
• While retains some degree of elasticity.

Dr. Tasir Ahmed

GENERAL STRUCTURE OF
LONG BONES.

• Epiphysis.
• Physis or Epiphyseal plate.
• Metaphysis.
• Diaphysis.

Dr. Tasir Ahmed

RADIOLOGY OF BONES

• Bone is Radio opaque & appears

white on X-rays.
• Cartilage is Radiolucent & cannot be
seen on X-rays.

Dr. Tasir Ahmed

SKELETAL TRAUMA.

• One of most common causes of X-ray request.

• Bones are excellently visualized on X-rays.
• Cartilage, muscles & tendons cannot be
visualized on X-rays.
• Trauma to these structures can be assessed
indirectly.
GENERAL PRINCIPLES OF
SKELETAL RADIOLOGY.
• At least 2 views at right angles should be taken.
• Supplementary views can be taken, if needed.
• Near by joint should be included in the radiograph.
• Good quality radiograph shows bony trabeculae
clearly.
• Over &under exposed films are avoided.

Dr. Tasir Ahmed

Dr. Tasir Ah
Dr. Tasir Ahmed
Dr. Tasir Ahmed
Dr. Tasir Ahmed
Dr. Tasir Ahmed
Dr. Tasir Ahmed
GENERAL PRINCIPLES OF
SKELETAL RADIOLOGY.

• Radiographs of normal counter parts helpful in

doubtful cases.
• Certain undisplaced fractures may invisible
immediately after injury.
• Repeat X-ray 10-20 days later is done, which then
shows callus formation and/ or bone resorption
confirming the fractures.

Dr. Tasir Ahmed

RADIOLOGICAL
EXAMINATION PERMITS
ASSESSMENT OF:

Dr. Tasir Ahmed

1- PRESENCE OF FRACTURE
BY SHOWING:

• Variation from normal anatomical contours.

• A break in cortical continuity.
• Disturbance of normal joint relationship.
• Presence of line of increased density
resulting from overriding of bone edges.

Dr. Tasir Ahmed

Dr. Tasir Ahmed
Dr. Tasir Ahmed
Dr. Tasir Ahmed
2- TYPES & POSITION OF
FRACTURE.

• Simple or compound.
• Dislocation or subluxation.
• Epiphyseal injury.
• Check X-ray after reduction to check the
degree of restoration of anatomical position.

Dr. Tasir Ahmed

3- ASSOCIATED SOFT
TISSUE INJURY.

• Joint effusion.
• Fat pad sign.
• Surgical emphysema.
• Presence of foreign body.

Dr. Tasir Ahmed

TYPES OF FRACTURES:
ACUTE FRACTURES.
• Green stick or Buckle fractures.
• Simple fractures:
– Linear.
– Transverse.
– Spiral/ Oblique.
• Comminuted.
• Compressed.
• Impacted.
• Compound.
FATIGUE/ STRESS
FRACTURES

– Repeated minor trauma e.g. Marching.

– Especially in metatarsals, tibia & fibula.
– Produces marked callus formation.
PATHOLOGICAL FRACTURES

#Secondary to bone diseases e.g.

• Osteoporosis.
• Hyperparathyroidism.
• Multiple myeloma.
• Tumors.
• Osteomyelitis.
• Bone cysts.
COMLICATIONS OF
FRACTURES:

• 1) Delayed Union. Still mobile after 4

months.
• 2) Non Union. No callus. Rounding &
sclerosis of bone margins.
•
COMLICATIONS OF
FRACTURES:

• 3) Necrosis. Mostly due to loss

of blood supply. Head of femur.
Scaphoid. Lunate. Body of
talus.
COMLICATIONS OF
FRACTURES:

• 4) Malunion. Malalignment.
Shortening. Angulation.
• 5) Joint complications. Dislocation.
Hemorrhage/ effusion.
COMLICATIONS OF
FRACTURES:
• 6) Fat embolism. Esp. after fractures of
long bones.
Occlusion of capillaries of lungs & brain by
fat globules.
• 7) Myositis Ossificans.
• 8) Osteoarthrosis.
COMLICATIONS OF
FRACTURES:
• 9) Sudeck’s Atrophy. Affects hands
& feet.
Painful swollen red skin distal to
fracture.
Loss of movements.
Osteopenia
4- AGE & HEALING OF
FRACTURES:
#Tubular Long Bones:

• Haematoma formation.
• Cellular proliferation of subperiosteal &
endosteal bone.
• Soft callus formation.
• Consolidation of callus.
• Remodeling.
# Cancellous Bone:

• Haematoma formation.
• Bridging new bone.
BONE UNION:

• In children—4-6 weeks for consolidation.

• In adults—4-6 months for consolidation.