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  • 𝐒𝐩𝐢𝐧𝐞 𝐂𝐨𝐧𝐬𝐮𝐥𝐭- 
𝐇𝐢𝐬𝐭𝐨𝐫𝐲: 
While many surgical cases have been scaled back during the COVID-19 ciris, there are still many spine pathologies and spinal cord traumas that occur and need intervention. Below is recent case of mine:
79-year-old male fell down several stairs at his skilled nursing home 1 day prior, initially brought to a peripheral hospital but due to a suspected spinal cord injury he was immediately transferred to our hospital, being the Regional Spinal Cord Injury Center of the Delaware Valley. He had pain, swelling, and bruising at hip right hip. Additionally he had decreased strength in his bilateral arms as well as his legs. The loss of function in his arms was more significant than the leg weakness. Urinary continence unable to be examined due to foley.

𝐈𝐦𝐚𝐠𝐢𝐧𝐠:
His MRI shows spinal cord signal intensity indicating swelling, edema and acute trauma. He has severe spinal stenosis C2-C4, moderate at C5, cord signal change C2-C3.
XR- Displaced right intertrochanteric femur fracture

𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬: 
1- Right intertrochanteric femur fracture 
2- Central Cord Syndrome (Incomplete Spinal Cord Injury)
3- Severe Cervical Spinal Stenosis

𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞: 
1- Intramedullary nailing of right femur (Fracture table)
2- Change table to Posterior Jackson table with Mayfield cranial stabilization; flip to prone
3- Posterior Cervical Laminectomy, C2-C5
4- Posterior Cervical Fusion, C2-C6

Thoughts? Alternative plans? Management Pearls?

#SpineConsult #spinedoctor #Orthospine #spinesurgery #Ortho #Orthopedic #Orthopaedic #neurosurgery #bonedoctor #spinefusion #neuroresident #matchday #matchday2020

#USMLE #JBJS #AmericanBoardofOrthopaedicSurgery #ABOS #AAOS2021
#Residency #RadiologyResidency #orthogrind #medschoolgrind
#physiciansassistant #PosteriorCervicalFusion #intertrochantericFemurFracture
#cervicalspine  #neuroexam #centralcordsyndrome
  • 𝐒𝐩𝐢𝐧𝐞 𝐂𝐨𝐧𝐬𝐮𝐥𝐭- 
    𝐇𝐢𝐬𝐭𝐨𝐫𝐲: 
    While many surgical cases have been scaled back during the COVID-19 ciris, there are still many spine pathologies and spinal cord traumas that occur and need intervention. Below is recent case of mine:
    79-year-old male fell down several stairs at his skilled nursing home 1 day prior, initially brought to a peripheral hospital but due to a suspected spinal cord injury he was immediately transferred to our hospital, being the Regional Spinal Cord Injury Center of the Delaware Valley. He had pain, swelling, and bruising at hip right hip. Additionally he had decreased strength in his bilateral arms as well as his legs. The loss of function in his arms was more significant than the leg weakness. Urinary continence unable to be examined due to foley.

    𝐈𝐦𝐚𝐠𝐢𝐧𝐠:
    His MRI shows spinal cord signal intensity indicating swelling, edema and acute trauma. He has severe spinal stenosis C2-C4, moderate at C5, cord signal change C2-C3.
    XR- Displaced right intertrochanteric femur fracture

    𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬: 
    1- Right intertrochanteric femur fracture
    2- Central Cord Syndrome (Incomplete Spinal Cord Injury)
    3- Severe Cervical Spinal Stenosis

    𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞: 
    1- Intramedullary nailing of right femur (Fracture table)
    2- Change table to Posterior Jackson table with Mayfield cranial stabilization; flip to prone
    3- Posterior Cervical Laminectomy, C2-C5
    4- Posterior Cervical Fusion, C2-C6

    Thoughts? Alternative plans? Management Pearls?

    #SpineConsult #spinedoctor #Orthospine #spinesurgery #Ortho #Orthopedic #Orthopaedic #neurosurgery #bonedoctor #spinefusion #neuroresident #matchday #matchday2020

    #USMLE #JBJS #AmericanBoardofOrthopaedicSurgery #ABOS #AAOS2021
    #Residency #RadiologyResidency #orthogrind #medschoolgrind
    #physiciansassistant #PosteriorCervicalFusion #intertrochantericFemurFracture
    #cervicalspine  #neuroexam #centralcordsyndrome

  •  135  6  7 hours ago
  • An 82-year-old female presents following a fall from standing. She was an active, independent, community ambulator prior to this event. Past surgical history is significant for a left total hip arthroplasty 9 years prior. A left hip XR is shown. CT demonstrates a displaced transverse acetabulum fracture with medial cup migration. No evidence of femoral component loosening or fracture. There is no concern for infection. Which treatment is most appropriate? .
A- Acetabular revision with a custom triflange implant
B- Dual approach pelvic ORIF and acetabular revision
C- Acetabular revision with cup-cage construct
D- Acetabular revision with placement of a jumbo cup
E- Restricted weight bearing
.
.
Reference: PMID: 25307882 J Arthroplasty. 2015 Feb;30(2):265-9. Epub 2014 Sep 28. Periprosthetic fractures of the acetabulum during cup insertion: posterior column stability is crucial.
.
#Ortho #Orthopedic #Orthopaedic #orthogrind #medschoolgrind #bonedoctor #matchday #matchday2020 #orthomatch #AmericanBoardofOrthopaedicSurgery #ABOS #AAOS2021
#Residency #RadiologyResidency #ORIF

#PAschool #physiciansassistant #orthopodsofinsta 
#arthroplasty #jointreplacement #jointinfection #hipsurgery #Trendelenburggait #orthorecon #THA #revisionTHA 
#womeninortho #internyear #diversityinsurgery
  • An 82-year-old female presents following a fall from standing. She was an active, independent, community ambulator prior to this event. Past surgical history is significant for a left total hip arthroplasty 9 years prior. A left hip XR is shown. CT demonstrates a displaced transverse acetabulum fracture with medial cup migration. No evidence of femoral component loosening or fracture. There is no concern for infection. Which treatment is most appropriate? .
    A- Acetabular revision with a custom triflange implant
    B- Dual approach pelvic ORIF and acetabular revision
    C- Acetabular revision with cup-cage construct
    D- Acetabular revision with placement of a jumbo cup
    E- Restricted weight bearing
    .
    .
    Reference: PMID: 25307882 J Arthroplasty. 2015 Feb;30(2):265-9. Epub 2014 Sep 28. Periprosthetic fractures of the acetabulum during cup insertion: posterior column stability is crucial.
    .
    #Ortho #Orthopedic #Orthopaedic #orthogrind #medschoolgrind #bonedoctor #matchday #matchday2020 #orthomatch #AmericanBoardofOrthopaedicSurgery #ABOS #AAOS2021
    #Residency #RadiologyResidency #ORIF

    #PAschool #physiciansassistant #orthopodsofinsta
    #arthroplasty #jointreplacement #jointinfection #hipsurgery #Trendelenburggait #orthorecon #THA #revisionTHA
    #womeninortho #internyear #diversityinsurgery

  •  139  19  6 April, 2020
  • 𝐏𝐮𝐛𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧-
2 great papers discussing Spinal Epidural Abscess.
1- Reviewed MRIs of patients with Spinal Epidural Abscess (SEA) to identify those with multiple “skip” lesions (n=22) vs single lesions (n=211) in the spinal column, showed 3 significant predictors: .
- Concomitant area of infection outside the spine and paraspinal region (UTI, lung, tooth, wound)
- Erythrocyte sedimentation rate (ESR) of >95 mm/h at presentation
- Delay in presentation (defined as symptoms for ≥7 days). .
The predicted probability for the presence of a “skip lesion” (infection at other site): 0/3- 0% skip lesion; 1/3- 2% skip lesion; 2/3- 13% skip lesion; 3/3- 73% skip lesion (Ju et al; The Spine Journal 2015)
.
2- Identified 4 independent risk factors that predict failure of non-operative (medical) management: .
- Diabetes mellitus
- C-reactive protein greater than 115
- white blood count greater than 12.5
- positive blood cultures (bacteremia)
.
Using these able to make a Predictor of non-operative failure: .
0/4- 8.3% failure; 1/4- 35.4% failure; 2/4- 40.2% failure; 3&4/4- 76.9% failure (Patel et al; The Spine Journal 2013)

Image 3- My washing out an retropharyngeal abscess with extension into the posterior cervical spine epidural space, also addressed from a posterior cervical decompression and fusion.

#SpineConsult #spinedoctor #spinesurgery #Ortho #Orthopedic #Orthopaedic #neurosurgery #bonedoctor #spinefusion #neuroresident #matchday #matchday2020

#OITE #USMLE #JBJS #AmericanBoardofOrthopaedicSurgery #ABOS #AAOS2021
#Orthospine #Residency #RadiologyResidency #orthogrind #medschoolgrind
#physiciansassistant #orthopodsofinsta #SpineNurse
#cervicalspine  #neuroexam #spinalepiduralabscess
  • 𝐏𝐮𝐛𝐥𝐢𝐜𝐚𝐭𝐢𝐨𝐧-
    2 great papers discussing Spinal Epidural Abscess.
    1- Reviewed MRIs of patients with Spinal Epidural Abscess (SEA) to identify those with multiple “skip” lesions (n=22) vs single lesions (n=211) in the spinal column, showed 3 significant predictors: .
    - Concomitant area of infection outside the spine and paraspinal region (UTI, lung, tooth, wound)
    - Erythrocyte sedimentation rate (ESR) of >95 mm/h at presentation
    - Delay in presentation (defined as symptoms for ≥7 days). .
    The predicted probability for the presence of a “skip lesion” (infection at other site): 0/3- 0% skip lesion; 1/3- 2% skip lesion; 2/3- 13% skip lesion; 3/3- 73% skip lesion (Ju et al; The Spine Journal 2015)
    .
    2- Identified 4 independent risk factors that predict failure of non-operative (medical) management: .
    - Diabetes mellitus
    - C-reactive protein greater than 115
    - white blood count greater than 12.5
    - positive blood cultures (bacteremia)
    .
    Using these able to make a Predictor of non-operative failure: .
    0/4- 8.3% failure; 1/4- 35.4% failure; 2/4- 40.2% failure; 3&4/4- 76.9% failure (Patel et al; The Spine Journal 2013)

    Image 3- My washing out an retropharyngeal abscess with extension into the posterior cervical spine epidural space, also addressed from a posterior cervical decompression and fusion.

    #SpineConsult #spinedoctor #spinesurgery #Ortho #Orthopedic #Orthopaedic #neurosurgery #bonedoctor #spinefusion #neuroresident #matchday #matchday2020

    #OITE #USMLE #JBJS #AmericanBoardofOrthopaedicSurgery #ABOS #AAOS2021
    #Orthospine #Residency #RadiologyResidency #orthogrind #medschoolgrind
    #physiciansassistant #orthopodsofinsta #SpineNurse
    #cervicalspine  #neuroexam #spinalepiduralabscess

  •  71  4  5 April, 2020
  • The Diagnostic Radiology Intern 🔎 @kendallscottcooper •
•
•
•

Hey! My name is Kendall Cooper and I’m a 4th year medical student who recently matched into diagnostic radiology at the Mayo Clinic in Rochester, MN. There were many aspects of the field of radiology that appealed to me. I’m a very visual person so the interpretation of imaging first put it on my radar. You get to play Where’s Waldo with every scan except Waldo might not even be present and meanwhile you get to utilize knowledge of pathophysiology and anatomy from every specialty to assist you in your search. Every case is a new fascinating puzzle. •

There is little wasted time while in the reading room because there are so many imaging studies ordered at hospitals which ensures practically every day is a mentally engaging and fast paced day in the reading room (which most people outside of radiology don’t think of it as fast paced). You also have the flexibility to perform short image guided procedures throughout the day such as a ultrasound guided breast biopsy, CT-guided kidney biopsy etc. •

Patients may not recognize your contributions directly, but radiologists have the ability to impact care on practically every patient in the hospital and that can be very internally satisfying. I hope my very brief spiel convinced you radiology is the best! Ok, other specialties are great too...but if you have any other questions about radiology please feel free to reach out to me!
  • The Diagnostic Radiology Intern 🔎 @kendallscottcooper




    Hey! My name is Kendall Cooper and I’m a 4th year medical student who recently matched into diagnostic radiology at the Mayo Clinic in Rochester, MN. There were many aspects of the field of radiology that appealed to me. I’m a very visual person so the interpretation of imaging first put it on my radar. You get to play Where’s Waldo with every scan except Waldo might not even be present and meanwhile you get to utilize knowledge of pathophysiology and anatomy from every specialty to assist you in your search. Every case is a new fascinating puzzle. •

    There is little wasted time while in the reading room because there are so many imaging studies ordered at hospitals which ensures practically every day is a mentally engaging and fast paced day in the reading room (which most people outside of radiology don’t think of it as fast paced). You also have the flexibility to perform short image guided procedures throughout the day such as a ultrasound guided breast biopsy, CT-guided kidney biopsy etc. •

    Patients may not recognize your contributions directly, but radiologists have the ability to impact care on practically every patient in the hospital and that can be very internally satisfying. I hope my very brief spiel convinced you radiology is the best! Ok, other specialties are great too...but if you have any other questions about radiology please feel free to reach out to me!

  •  85  2  4 April, 2020
  • English text in comments.
Первоначально я думал, что это шизенцефалия, но я ошибался 😥. Да простят меня те, кого я ввёл в заблуждение. Спасибо @dr_andros and  @layspapita сейчас то, что раскрыли глаза на правду!
Полимикрогирия Сильвиевой щели это достаточно редкая аномалия головного мозга. Серое вещество аномально расположено с поверхностными мелкими единичными бороздами. 
Является результатом постмиграционного инсульта коры на 6-7 мес. беременности.

Синдром может быть как односторонним так и двусторонним. ✔Клинически при двустороннем синдроме отмечается псевдобульбарный паралич, расстройства речи, задержка развития и эпилепсия. 
Односторонний синдром протекает легче и сопровождается чаще только эпилепсией, иногда с нарушением речи.
⚛МРТ проявления:
▪Глубокая Сильвиева щель.
▪По краям щели - толстый слой серого вещества с гладким контуром (могут быть мелкие поверхностные извилины).
▪Серое вещество деформирует край бокового желудочка. ❗От шизенцефалии отличается тем, что щель не доходит до бокового желудочка. ❓Вопросы? Комментарии?

#радиология #рентгенология #нейрорадиология #неврология  #рентгенолог #врач #лучеваядиагностика #ординатуралучевая #медицина #медобразование #медик #медстудент #МРТ #мртголовногомозга #эпилепсия #аномалия #radiology #radiologist #neuroradiology #neurology #medicine #medicalstudent #radiologyresidency #medical #medicalstudy  #mri #mriofthebrain #epilepsia #anomaly #FOAMrad
  • English text in comments.
    Первоначально я думал, что это шизенцефалия, но я ошибался 😥. Да простят меня те, кого я ввёл в заблуждение. Спасибо @dr_andros and @layspapita сейчас то, что раскрыли глаза на правду!
    Полимикрогирия Сильвиевой щели это достаточно редкая аномалия головного мозга. Серое вещество аномально расположено с поверхностными мелкими единичными бороздами.
    Является результатом постмиграционного инсульта коры на 6-7 мес. беременности.

    Синдром может быть как односторонним так и двусторонним. ✔Клинически при двустороннем синдроме отмечается псевдобульбарный паралич, расстройства речи, задержка развития и эпилепсия.
    Односторонний синдром протекает легче и сопровождается чаще только эпилепсией, иногда с нарушением речи.
    ⚛МРТ проявления:
    ▪Глубокая Сильвиева щель.
    ▪По краям щели - толстый слой серого вещества с гладким контуром (могут быть мелкие поверхностные извилины).
    ▪Серое вещество деформирует край бокового желудочка. ❗От шизенцефалии отличается тем, что щель не доходит до бокового желудочка. ❓Вопросы? Комментарии?

    #радиология #рентгенология #нейрорадиология #неврология #рентгенолог #врач #лучеваядиагностика #ординатуралучевая #медицина #медобразование #медик #медстудент #МРТ #мртголовногомозга #эпилепсия #аномалия #radiology #radiologist #neuroradiology #neurology #medicine #medicalstudent #radiologyresidency #medical #medicalstudy #mri #mriofthebrain #epilepsia #anomaly #FOAMrad

  •  197  15  2 April, 2020
  • Encephalocraniocutaneous lipomatosis—image 1 depicts large lipomas in cerebelloopontine angle and cisterna magna

A rare neurocutaneous disorder
Also called as Fishman syndrome or Haberland syndrome

Benign lipomas in brain and spinal cord—as depicted in image 1
Ocular choriostomas(lipodermoids)
Hair less scalp lipoma as depicted in image 2
Arachnoid cysts and meningioangiomatosis may be associated

#ctscan #radiology #radiologyworld #neetpg #usmle #madrads #signsinradiology #radiologyresidency #mri #mskimaging #learningtogether #ctbrain #raredisease #quarantinereading #medschool #acr #radiographics #rsna #radiopedia #osborn #neuroradiology
  • Encephalocraniocutaneous lipomatosis—image 1 depicts large lipomas in cerebelloopontine angle and cisterna magna

    A rare neurocutaneous disorder
    Also called as Fishman syndrome or Haberland syndrome

    Benign lipomas in brain and spinal cord—as depicted in image 1
    Ocular choriostomas(lipodermoids)
    Hair less scalp lipoma as depicted in image 2
    Arachnoid cysts and meningioangiomatosis may be associated

    #ctscan #radiology #radiologyworld #neetpg #usmle #madrads #signsinradiology #radiologyresidency #mri #mskimaging #learningtogether #ctbrain #raredisease #quarantinereading #medschool #acr #radiographics #rsna #radiopedia #osborn #neuroradiology

  •  39  0  1 April, 2020
  • The State University of New York - Downstate Health Sciences University is answering Governor Andrew M. Cuomo’s directive to prepare University Hospital of Brooklyn as a COVID-19 only facility. We are working closely with neighboring hospitals to transfer patients and continue the highest level of care that our patients, their families, and the community expect.

Our heroes on the front lines and other essential staff are working around the clock to care for COVID-19 patients and those with related symptoms. We will work tirelessly with our partners at every level to prepare for the challenges ahead, and stand ready with them to meet those efforts with perseverance and compassion to combat the anticipated COVID-19 apex and save lives.

University Hospital of Brooklyn’s dedicated medical, nursing, respiratory therapy, environmental services, and other professional staff remain ready to care for COVID-19 patients as we had been doing since our first patient a few weeks ago.

#Covid19 #Covid #CoronaVirus #NYC #SUNY #Downstate #Radiology #Residency #RadRes #Cancer #NYRS #IR #IRad #InterventionalRadiology #Radiologist #CT #MRI #Xray #X-Ray #MedEd #Medicine #MedicalEducation #RadiologyResidency #Brooklyn #BK #KingsCounty #University #Hospital #NYC #NewYork #NewYorkCity
  • The State University of New York - Downstate Health Sciences University is answering Governor Andrew M. Cuomo’s directive to prepare University Hospital of Brooklyn as a COVID-19 only facility. We are working closely with neighboring hospitals to transfer patients and continue the highest level of care that our patients, their families, and the community expect.

    Our heroes on the front lines and other essential staff are working around the clock to care for COVID-19 patients and those with related symptoms. We will work tirelessly with our partners at every level to prepare for the challenges ahead, and stand ready with them to meet those efforts with perseverance and compassion to combat the anticipated COVID-19 apex and save lives.

    University Hospital of Brooklyn’s dedicated medical, nursing, respiratory therapy, environmental services, and other professional staff remain ready to care for COVID-19 patients as we had been doing since our first patient a few weeks ago.

    #Covid19 #Covid #CoronaVirus #NYC #SUNY #Downstate #Radiology #Residency #RadRes #Cancer #NYRS #IR #IRad #InterventionalRadiology #Radiologist #CT #MRI #Xray #X-Ray #MedEd #Medicine #MedicalEducation #RadiologyResidency #Brooklyn #BK #KingsCounty #University #Hospital #NYC #NewYork #NewYorkCity

  •  23  0  31 March, 2020
  • .
| 𝙄𝙣𝙘𝙞𝙙𝙚𝙣𝙩𝙖𝙡 |

6 YO male had an Xray done for an unrelated cause.
Fracture Mimics- Harris Lines
AKA growth arrest lines AKA growth resumption lines.
.
⭕️Alternating transverse rings of sclerosis in the metaphysis of the long bones.Condensation of normal bone.
.
⭕️Always parallel to the physis and represent the slowing or cessation of growth.
.
⭕️Usually bilateral.The lines do not become visible until after normal growth resumes.Subsequent investigation does not confirm a definitive relationship between their occurrence and episodes of deprivation but of periods of rapid growth.
.
⭕️	Perpendicular to long axis of bone.Metaphyseal at first.Most marked in rapidly growing ends of bones, e.g. distal femur and proximal tibia.They migrate towards the diaphysis with further growth and may disappear .
⭕️ddx- Rickets, bisphosphonate therapy, treated leukemia.

#radiology #harrislines #xray #xraytech #incidental #radiologia #radiologyresident #radiologyresidency #leadpoisoning #orthopedicsurgery #orthopedics
  • .
    | 𝙄𝙣𝙘𝙞𝙙𝙚𝙣𝙩𝙖𝙡 |

    6 YO male had an Xray done for an unrelated cause.
    Fracture Mimics- Harris Lines
    AKA growth arrest lines AKA growth resumption lines.
    .
    ⭕️Alternating transverse rings of sclerosis in the metaphysis of the long bones.Condensation of normal bone.
    .
    ⭕️Always parallel to the physis and represent the slowing or cessation of growth.
    .
    ⭕️Usually bilateral.The lines do not become visible until after normal growth resumes.Subsequent investigation does not confirm a definitive relationship between their occurrence and episodes of deprivation but of periods of rapid growth.
    .
    ⭕️ Perpendicular to long axis of bone.Metaphyseal at first.Most marked in rapidly growing ends of bones, e.g. distal femur and proximal tibia.They migrate towards the diaphysis with further growth and may disappear .
    ⭕️ddx- Rickets, bisphosphonate therapy, treated leukemia.

    #radiology #harrislines #xray #xraytech #incidental #radiologia #radiologyresident #radiologyresidency #leadpoisoning #orthopedicsurgery #orthopedics

  •  65  0  31 March, 2020
  • English text in comments.
🇷🇺 Множественная системная атрофия (Паркинсонический вариант) или стриатонигральная дегенерация. ✔Один из вариантов МСА, клинически проявляется синдромом Паркинсонизма.
✔Морфологически - гибель клеток и глиоз в пораженных зонах (в первую очередь в области скорлупы чечевицеобразного ядра, и в чёрной субстанции). ⚛МРТ - изменения в зоне скорлупы:
▪Уменьшение размера за счёт гибели клеток.
▪Снижение сигнала в режимах Т2SE и T2GRE относительно бледного шара и красных ядер за счёт депонирования железа в клетках ▪Симптом "ободка скорлупы" - в режиме Т2 по периферии определяется линейная полоса Т2 интенсивного сигнала - "глиозный рубец". (❗симптом актуален для аппарата 1,5 Тесла. На 3-х Тесловых аппаратах этот симптом присутствует в норме).
❓Вопросы? Комментарии? Буду рад! Делитесь с коллегами!

#радиология #рентгенология #нейрорадиология #неврология #рентгенолог #врач #лучеваядиагностика #ординатуралучевая #медицина #медобразование #медик #медстудент #МРТ #мртголовногомозга #рждмедицина #radiology #radiologist #neuroradiology #neurology #medicine #medicalstudent #radiologyresidency #medical #medicalstudy  #mri #mriofthebrain  #FOAMrad
  • English text in comments.
    🇷🇺 Множественная системная атрофия (Паркинсонический вариант) или стриатонигральная дегенерация. ✔Один из вариантов МСА, клинически проявляется синдромом Паркинсонизма.
    ✔Морфологически - гибель клеток и глиоз в пораженных зонах (в первую очередь в области скорлупы чечевицеобразного ядра, и в чёрной субстанции). ⚛МРТ - изменения в зоне скорлупы:
    ▪Уменьшение размера за счёт гибели клеток.
    ▪Снижение сигнала в режимах Т2SE и T2GRE относительно бледного шара и красных ядер за счёт депонирования железа в клетках ▪Симптом "ободка скорлупы" - в режиме Т2 по периферии определяется линейная полоса Т2 интенсивного сигнала - "глиозный рубец". (❗симптом актуален для аппарата 1,5 Тесла. На 3-х Тесловых аппаратах этот симптом присутствует в норме).
    ❓Вопросы? Комментарии? Буду рад! Делитесь с коллегами!

    #радиология #рентгенология #нейрорадиология #неврология #рентгенолог #врач #лучеваядиагностика #ординатуралучевая #медицина #медобразование #медик #медстудент #МРТ #мртголовногомозга #рждмедицина #radiology #radiologist #neuroradiology #neurology #medicine #medicalstudent #radiologyresidency #medical #medicalstudy #mri #mriofthebrain #FOAMrad

  •  124  9  31 March, 2020
  • Explanation to previous spotter  Extramedullary hematopoesis 
The PA film demonstrates bilateral mediastinal masses
The left and right heart borders are clearly visible,as are the hilar vessels
Implying posterior mediastinal masses

Confirmed on lateral film,where soft tissue masses are overlying thoracic spine
Additionally the bones are markedly abnormal..ribs expanded anteriorly;osteopenia with a coarse trabecular pattern—marrow hyperplasia accounts for this changes
The patient was a known case of thalesemia major 
History helps to narrow down the differential in this case  #ctscan #radiology #radiologyworld #neetpg #usmle #madrads #signsinradiology #radiologyresidency #mri #mskimaging #xray #chestxray #rarecases #learningtogether #residency
  • Explanation to previous spotter Extramedullary hematopoesis
    The PA film demonstrates bilateral mediastinal masses
    The left and right heart borders are clearly visible,as are the hilar vessels
    Implying posterior mediastinal masses

    Confirmed on lateral film,where soft tissue masses are overlying thoracic spine
    Additionally the bones are markedly abnormal..ribs expanded anteriorly;osteopenia with a coarse trabecular pattern—marrow hyperplasia accounts for this changes
    The patient was a known case of thalesemia major
    History helps to narrow down the differential in this case #ctscan #radiology #radiologyworld #neetpg #usmle #madrads #signsinradiology #radiologyresidency #mri #mskimaging #xray #chestxray #rarecases #learningtogether #residency

  •  60  0  31 March, 2020
  • 𝐒𝐩𝐢𝐧𝐞 𝐂𝐨𝐧𝐬𝐮𝐥𝐭- 
𝐇𝐢𝐬𝐭𝐨𝐫𝐲: 
73-year-old woman who fell sustaining a 𝘵𝘺𝘱𝘦 2 𝘰𝘥𝘰𝘯𝘵𝘰𝘪𝘥 𝘧𝘳𝘢𝘤𝘵𝘶𝘳𝘦. Various options for surgical versus nonsurgical treatment were reviewed. Given the quality of her bone, the alignment of the fracture relative to the odontoid and her overall good health, an osteosynthesis procedure with an anterior odontoid (lag) screw was recommended.

𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬: 
Type II Odontoid Fracture

𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞: 
1- Odontoid Osteosynthesis with Screw Fixation (#Synthes 4-0 Partially Threaded Screw)

𝐓𝐞𝐜𝐡𝐧𝐢𝐪𝐮𝐞:
A standard Smith-Robinson approach was performed on the left side 2-1/2 fingerbreadths below the left clavicle, dissecting it down to the anterior longitudinal ligament of the cervical spine and then dissecting cephalad up to the C2-3 disk space.  A Kerlix roll in the mouth to hold the mouth open for visualization of the odontoid process on the AP x-ray. With fluoroscopy, we used Bovie on to the C2-3 disk space (patient has a fused C2-3 facilitating placement of the screw into the C2-3 disk space). We then took the Midas Rex bur and advanced a 2.5 mm diameter drill up through the body of C2 across the fracture into the proximal odontoid fragment. Next, we took a 3.2 mm drill and drilled just through the body but not into the distal fragment. Next, we took a tap and tapped all the way to the tip of the odontoid. We measured this for a 38 mm long odontoid screw. We took the screw which was 4 mm diameter cancellous thread with only the distal 10 mm threaded. We placed the screw under fluoroscopic guidance on AP and lateral fluoroscopy through the body and up into the odontoid fragment. We brought the hub of the screw right up into the base of the C2 vertebral body to allow us to compress the proximal odontoid fragment down along the fracture line. We then irrigated the wound and re-approximated tissue with suture. 
Thoughts? Alternative plans? Management Pearls?
  • 𝐒𝐩𝐢𝐧𝐞 𝐂𝐨𝐧𝐬𝐮𝐥𝐭- 
    𝐇𝐢𝐬𝐭𝐨𝐫𝐲: 
    73-year-old woman who fell sustaining a 𝘵𝘺𝘱𝘦 2 𝘰𝘥𝘰𝘯𝘵𝘰𝘪𝘥 𝘧𝘳𝘢𝘤𝘵𝘶𝘳𝘦. Various options for surgical versus nonsurgical treatment were reviewed. Given the quality of her bone, the alignment of the fracture relative to the odontoid and her overall good health, an osteosynthesis procedure with an anterior odontoid (lag) screw was recommended.

    𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬: 
    Type II Odontoid Fracture

    𝐏𝐫𝐨𝐜𝐞𝐝𝐮𝐫𝐞: 
    1- Odontoid Osteosynthesis with Screw Fixation ( #Synthes 4-0 Partially Threaded Screw)

    𝐓𝐞𝐜𝐡𝐧𝐢𝐪𝐮𝐞:
    A standard Smith-Robinson approach was performed on the left side 2-1/2 fingerbreadths below the left clavicle, dissecting it down to the anterior longitudinal ligament of the cervical spine and then dissecting cephalad up to the C2-3 disk space.  A Kerlix roll in the mouth to hold the mouth open for visualization of the odontoid process on the AP x-ray. With fluoroscopy, we used Bovie on to the C2-3 disk space (patient has a fused C2-3 facilitating placement of the screw into the C2-3 disk space). We then took the Midas Rex bur and advanced a 2.5 mm diameter drill up through the body of C2 across the fracture into the proximal odontoid fragment. Next, we took a 3.2 mm drill and drilled just through the body but not into the distal fragment. Next, we took a tap and tapped all the way to the tip of the odontoid. We measured this for a 38 mm long odontoid screw. We took the screw which was 4 mm diameter cancellous thread with only the distal 10 mm threaded. We placed the screw under fluoroscopic guidance on AP and lateral fluoroscopy through the body and up into the odontoid fragment. We brought the hub of the screw right up into the base of the C2 vertebral body to allow us to compress the proximal odontoid fragment down along the fracture line. We then irrigated the wound and re-approximated tissue with suture.
    Thoughts? Alternative plans? Management Pearls?

  •  210  9  30 March, 2020
  • Classic Superficial siderosis 
T2WI shows linear hypointensity around the surfaces of the pons and cerebellum ,medulla and spinal cord. T2* GRE scans will show marked "blooming".
2 types:
Classical SS • Posterior fossa > > supratentorial Brain (typically cerebellum), cranial nerves coated with hemosiderin 
Chronic repeated SAH 
Cause undetermined in ≈ 50% Sensorineural hearing loss 
Cortical SS • Cortex over hemisphere convexities 
Most common etiology = CAA (cerebral amyloid angioplasty)
Transient focal neurologic episodes Parallel "track-like" hypointensities on T2* 
High risk of future intracerebral hemorrhage ,Lobar hemorrhages, microbleeds  #ctscan #radiology #mribrain #radiologyworld #neetpg #usmle #madrads #signsinradiology #radiologyresidency #mri #neuroradiology #frcr #interestingcases
  • Classic Superficial siderosis
    T2WI shows linear hypointensity around the surfaces of the pons and cerebellum ,medulla and spinal cord. T2* GRE scans will show marked "blooming".
    2 types:
    Classical SS • Posterior fossa > > supratentorial Brain (typically cerebellum), cranial nerves coated with hemosiderin
    Chronic repeated SAH
    Cause undetermined in ≈ 50% Sensorineural hearing loss
    Cortical SS • Cortex over hemisphere convexities
    Most common etiology = CAA (cerebral amyloid angioplasty)
    Transient focal neurologic episodes Parallel "track-like" hypointensities on T2*
    High risk of future intracerebral hemorrhage ,Lobar hemorrhages, microbleeds #ctscan #radiology #mribrain #radiologyworld #neetpg #usmle #madrads #signsinradiology #radiologyresidency #mri #neuroradiology #frcr #interestingcases

  •  44  0  30 March, 2020
  • English text in comments.
🇷🇺Женщина 80 лет поступила планово с сахарным диабетом. ☢Во время рентгенографии органов грудной клетки выявлено небольшое округлое полостное образование, подтвержденное рентгеноскопически.
✔В условиях приемного покоя больше данных из анамнеза выяснить не удалось. Рекомендована КТ.
☢Через неделю проведена компьютерная томография. ▪Выявлены множественные округлые узлы разного калибра с полостями распада.
▪ к каждой полости подходит сосуд ("симптом питающего сосуда"). ✔Известно, что у пациентки хронический синусит.
❗Основное предположение: септическая пневмония.
Дифференцировать с гранулематозом Вегенера (поражение пазух и лёгких).
Из истории болезни: в крови лейкоцитоз и ускорение СОЭ.  Учитывая предполагаемый иммунодефицит при СД склоняюсь в сторону септической пневмонии.
☢КТ ППН выявляет синусит с деструкцией стенок левой верхнечелюстной пазухи. В лобной пазухе в структуре мягкотканного компонента аморфные кальцинаты.
✔Все это очень характерно для хронического инвазивного грибкового синусита.
➡Пациентка отправлена в ЛОР отделение для хирургического лечения.
❓Вопрос к @iv3265 @strokov_r и @viktoriakuts. Хочу выделить Ваши ответы. До КТ пазух я и предположить не мог грибковую этиологию, а Вы предположили и ведь верно. По каким критериям?😎👍👏. #радиология #рентгенология #рентгенолог #пульмонология #отоларингология #врач #ординатуралучевая #медицина #медик #медобразование #медстудент  #рентгеногк #кт #ктогк #ктппн #septicpneumonia CT#рждмедицина 
#radiology #radiologist #radiologyresidency #pulmonology #medicine #medical #medicalstudy #medicalstudent #medicaldoctor #chestxray #chestct #sinusct #FOAMrad
  • English text in comments.
    🇷🇺Женщина 80 лет поступила планово с сахарным диабетом. ☢Во время рентгенографии органов грудной клетки выявлено небольшое округлое полостное образование, подтвержденное рентгеноскопически.
    ✔В условиях приемного покоя больше данных из анамнеза выяснить не удалось. Рекомендована КТ.
    ☢Через неделю проведена компьютерная томография. ▪Выявлены множественные округлые узлы разного калибра с полостями распада.
    ▪ к каждой полости подходит сосуд ("симптом питающего сосуда"). ✔Известно, что у пациентки хронический синусит.
    ❗Основное предположение: септическая пневмония.
    Дифференцировать с гранулематозом Вегенера (поражение пазух и лёгких).
    Из истории болезни: в крови лейкоцитоз и ускорение СОЭ. Учитывая предполагаемый иммунодефицит при СД склоняюсь в сторону септической пневмонии.
    ☢КТ ППН выявляет синусит с деструкцией стенок левой верхнечелюстной пазухи. В лобной пазухе в структуре мягкотканного компонента аморфные кальцинаты.
    ✔Все это очень характерно для хронического инвазивного грибкового синусита.
    ➡Пациентка отправлена в ЛОР отделение для хирургического лечения.
    ❓Вопрос к @iv3265 @strokov_r и @viktoriakuts. Хочу выделить Ваши ответы. До КТ пазух я и предположить не мог грибковую этиологию, а Вы предположили и ведь верно. По каким критериям?😎👍👏. #радиология #рентгенология #рентгенолог #пульмонология #отоларингология #врач #ординатуралучевая #медицина #медик #медобразование #медстудент #рентгеногк #кт #ктогк #ктппн #septicpneumonia CT#рждмедицина
    #radiology #radiologist #radiologyresidency #pulmonology #medicine #medical #medicalstudy #medicalstudent #medicaldoctor #chestxray #chestct #sinusct #FOAMrad

  •  188  14  29 March, 2020
  • A 42 year old Hispanic telecommunications worker presented to our ED after mistakenly grabbing a "hot line" and suffering a high voltage electrocution into his left arm. He sustained 3rd degree #highvoltageburn . He will be managed with a formal operative debridement and daily dressing changes. Orthopedic surgery also manages extensive soft tissue and muscle injuries (in addition to bone). A severe burn injury or degloving injury would be managed by orthopedics as well as the primary admitting team. For electric burns, what additional concerns should be raised with the patient and his primary team?
.
.
A- delayed vision loss
B- hypoglycemic shock
C- compartment syndrome
D- cauda equina syndrome
E- deep vein thrombosis .
. (Last picture is different patient⚡🔥, almost identical pathology. This happened a lot 😮)
#Ortho #Orthopedic #Orthopaedic #AAOS2020 #Residency #OITE #USMLE #MCAT #SATprep #Orthotrauma #RadiologyResidency #bonedoctor #matchday2020 #handdoctor #plasticsurgery #AJHS #dermatology #RadiologyResidency #bonedoctor #orthogrind #medschoolgrind #PAschool #orthomatch #physiciansassistant #womeninortho #internyear #diversityinsurgery #electricalburn #compartmentsyndrome #AmericanBoardofOrthopaedicSurgery #ABOS
  • A 42 year old Hispanic telecommunications worker presented to our ED after mistakenly grabbing a "hot line" and suffering a high voltage electrocution into his left arm. He sustained 3rd degree #highvoltageburn . He will be managed with a formal operative debridement and daily dressing changes. Orthopedic surgery also manages extensive soft tissue and muscle injuries (in addition to bone). A severe burn injury or degloving injury would be managed by orthopedics as well as the primary admitting team. For electric burns, what additional concerns should be raised with the patient and his primary team?
    .
    .
    A- delayed vision loss
    B- hypoglycemic shock
    C- compartment syndrome
    D- cauda equina syndrome
    E- deep vein thrombosis .
    . (Last picture is different patient⚡🔥, almost identical pathology. This happened a lot 😮)
    #Ortho #Orthopedic #Orthopaedic #AAOS2020 #Residency #OITE #USMLE #MCAT #SATprep #Orthotrauma #RadiologyResidency #bonedoctor #matchday2020 #handdoctor #plasticsurgery #AJHS #dermatology #RadiologyResidency #bonedoctor #orthogrind #medschoolgrind #PAschool #orthomatch #physiciansassistant #womeninortho #internyear #diversityinsurgery #electricalburn #compartmentsyndrome #AmericanBoardofOrthopaedicSurgery #ABOS

  •  274  22  29 March, 2020
  • Cortical  nephrocalcinosis  is  an  uncommon  imaging f inding.  The  most  common cause  of  cortical  nephrocalcinosis  is  chronic  glomerulonephritis,  in  which  chronic  renal  failure  is  associated with  marked  renal  atrophy  with  smooth  renal  contours. Shell-like  calcifications  develop  in  the  renal  cortex  in  a small  number  of  these  patients  and  persist  even  after successful  renal  transplantation  and  normalization  of renal  function.  These  calcifications  are  likely  to  be  dystrophic  and  related  to  chronic  renal  cortical  ischemia. 
#medical#medlife#medschool#radiology#residency#radeducation#radio#radlife#radiologyresidency#medicalmission#imaging#radiodiagnosis#CT#Xray#MRI#USG#PET#radiology#MD#radioperals#radiomaniacs#DNB#NEET#AIIMS#PGI#jipmer#usmle#radiology#RADezy
  • Cortical nephrocalcinosis is an uncommon imaging f inding. The most common cause of cortical nephrocalcinosis is chronic glomerulonephritis, in which chronic renal failure is associated with marked renal atrophy with smooth renal contours. Shell-like calcifications develop in the renal cortex in a small number of these patients and persist even after successful renal transplantation and normalization of renal function. These calcifications are likely to be dystrophic and related to chronic renal cortical ischemia.
    #medical #medlife #medschool #radiology #residency #radeducation #radio #radlife #radiologyresidency #medicalmission#imaging#radiodiagnosis#CT#Xray#MRI#USG#PET#radiology#MD#radioperals#radiomaniacs#DNB#NEET#AIIMS#PGI#jipmer#usmle#radiology#RADezy

  •  25  0  29 March, 2020
  • In  medullary  nephrocalcinosis,  calcifications  are  limited  to  the  renal  pyramids,  which  are arrayed  in  a  central,  triangular  orientation  away  from the  calyces.  The  base  of  these  triangles  is situated  at  the  corticomedullary  junction  of  the  renal parenchyma.  These  calcified  renal  pyramids  are  separated  by  unaffected  renal  parenchyma  representing columns  of  renal  cortex. 
#renal#bodyimaging#radiology#residency#radiologyeducation#radio#radlife#radiologyresidency#medicalmission#imaging#radiodiagnosis#CT#Xray#MRI#USG#PET#radiology#MD#radioperals#radiomaniacs#DNB#NEET#AIIMS#PGI#jipmer#usmle#radiology #abdominalimaging #RADezy
  • In medullary nephrocalcinosis, calcifications are limited to the renal pyramids, which are arrayed in a central, triangular orientation away from the calyces. The base of these triangles is situated at the corticomedullary junction of the renal parenchyma. These calcified renal pyramids are separated by unaffected renal parenchyma representing columns of renal cortex.
    #renal #bodyimaging #radiology #residency #radiologyeducation #radio #radlife #radiologyresidency #medicalmission #imaging#radiodiagnosis#CT#Xray#MRI#USG#PET#radiology#MD#radioperals#radiomaniacs#DNB#NEET#AIIMS#PGI#jipmer#usmle#radiology #abdominalimaging #RADezy

  •  39  1  29 March, 2020
  • A 71 year-old mechanic with a Total Hip Arthroplasty (#THA) four years prior comes to the ER with acute hip pain after tying his shoes an hour ago. He can not ambulate and thigh is internally rotated. An AP pelvis is shown above. All of the following are independent risk factors for this current condition after having a total hip arthroplasty EXCEPT?
.
A- Post traumatic osteoarthritis of the hip
B- A female gender
C- #Osteonecrosis of the hip
D- Inflammatory arthritis
E- Age >70 years
.
.
.
.
.
.
SOURCE- Berry DJ, J Bone Joint Surg Am. 2004 ; Answer- A.
.
 The patient has a dislocated THA.
.
A closed reduction in the ER is usually possible about 2/3rds of the time. The patient may need a surgical revision of their THA if they have had 2 dislocations. Other reasons might be if there is #polyethylene wear or malalignment (XR shows that there is 1- vertical acetabular component or 2- acetabular retroversion which is the is also a common reason hardware failure). .
#Arthroplasty #hipsurgery #hipReplacement #THAdislocation .
#Ortho #Orthopedic #Orthopaedic #AAOS2030 #Residency  #medicalEducation #Orthotrauma  #hildoctor #evidencebasedmedicine #RadiologyResidency #bonedoctor #orthogrind #medschoolgrind #premed #hipSurgery #periprosthetichipfracture #hiparthritis #revisionTHA #VancouverClassification 
Repost @standardizedortho
  • A 71 year-old mechanic with a Total Hip Arthroplasty ( #THA) four years prior comes to the ER with acute hip pain after tying his shoes an hour ago. He can not ambulate and thigh is internally rotated. An AP pelvis is shown above. All of the following are independent risk factors for this current condition after having a total hip arthroplasty EXCEPT?
    .
    A- Post traumatic osteoarthritis of the hip
    B- A female gender
    C- #Osteonecrosis of the hip
    D- Inflammatory arthritis
    E- Age >70 years
    .
    .
    .
    .
    .
    .
    SOURCE- Berry DJ, J Bone Joint Surg Am. 2004 ; Answer- A.
    .
    The patient has a dislocated THA.
    .
    A closed reduction in the ER is usually possible about 2/3rds of the time. The patient may need a surgical revision of their THA if they have had 2 dislocations. Other reasons might be if there is #polyethylene wear or malalignment (XR shows that there is 1- vertical acetabular component or 2- acetabular retroversion which is the is also a common reason hardware failure). .
    #Arthroplasty #hipsurgery #hipReplacement #THAdislocation .
    #Ortho #Orthopedic #Orthopaedic #AAOS2030 #Residency #medicalEducation #Orthotrauma #hildoctor #evidencebasedmedicine #RadiologyResidency #bonedoctor #orthogrind #medschoolgrind #premed #hipSurgery #periprosthetichipfracture #hiparthritis #revisionTHA #VancouverClassification
    Repost @standardizedortho

  •  16  0  28 March, 2020
  • CHRONIC RENAL INSUFFICIENCY
In chronic renal insufficiency, reduced renal filtration causes phosphate retention and decreased calcitriol synthesis. This results in lowered serum calcium which in turn stimulates parathyroid hormone (PTH) secretion, thus causing secondary hyperparathyroidism. In order to elevate blood calcium levels, PTH increases bone resorption by stimulating osteoclast activity. Osteoblasts respond by depositing osteoid that does not contain hydroxyapatite, which then accumulates along the inferior and superior end plates of vertebra. The aforementioned areas of osteoid appear opaque at radiography due to their increased volume compared to the normal bone, resulting in the appearance known as ''rugger jersey spine'' because of its resemblance to the horizontal stripes on jerseys worn by rugby players

#medical#medlife#medschool#radiology#residency#radeducation#radio#radlife#radiologyresidency#medicalmission#imaging#radiodiagnosis#CT#Xray#MRI#USG#PET#radiology#MD#radioperals#radiomaniacs#DNB#NEET#AIIMS#PGI#jipmer#usmle#radiology#neurorad#mskradiology #RADezy
  • CHRONIC RENAL INSUFFICIENCY
    In chronic renal insufficiency, reduced renal filtration causes phosphate retention and decreased calcitriol synthesis. This results in lowered serum calcium which in turn stimulates parathyroid hormone (PTH) secretion, thus causing secondary hyperparathyroidism. In order to elevate blood calcium levels, PTH increases bone resorption by stimulating osteoclast activity. Osteoblasts respond by depositing osteoid that does not contain hydroxyapatite, which then accumulates along the inferior and superior end plates of vertebra. The aforementioned areas of osteoid appear opaque at radiography due to their increased volume compared to the normal bone, resulting in the appearance known as ''rugger jersey spine'' because of its resemblance to the horizontal stripes on jerseys worn by rugby players

    #medical #medlife #medschool #radiology #residency #radeducation #radio #radlife #radiologyresidency #medicalmission#imaging#radiodiagnosis#CT#Xray#MRI#USG#PET#radiology#MD#radioperals#radiomaniacs#DNB#NEET#AIIMS#PGI#jipmer#usmle#radiology#neurorad#mskradiology #RADezy

  •  17  0  28 March, 2020
  • Sickle  cell disease

Sagittal  CT  reformat  demonstrates  the classic  central  end-plate  collapse  termed  an  H-shaped  vertebra (arrows)  at multiple  levels.  The  sickled  cells  may  sludge  in  the  looping  arcades  at the  end  plates  of  the  vertebral  bodies,  causing  them  to  collapse  in  their central portion.

#medical#medlife#medschool#radiology#residency#radeducation#radio#radlife#radiologyresidency#medicalmission#imaging#radiodiagnosis#CT#Xray#MRI#USG#PET#radiology#MD#radioperals#radiomaniacs #radezy #AIIMS #NEET
  • Sickle cell disease

    Sagittal CT reformat demonstrates the classic central end-plate collapse termed an H-shaped vertebra (arrows) at multiple levels. The sickled cells may sludge in the looping arcades at the end plates of the vertebral bodies, causing them to collapse in their central portion.

    #medical #medlife #medschool #radiology #residency #radeducation #radio #radlife #radiologyresidency #medicalmission#imaging#radiodiagnosis#CT#Xray#MRI#USG#PET#radiology#MD#radioperals#radiomaniacs #radezy #AIIMS #NEET

  •  15  0  28 March, 2020
  • A 71 year-old mechanic with a Total Hip Arthroplasty (#THA) four years prior comes to the ER with acute hip pain after tying his shoes an hour ago. He can not ambulate and thigh is internally rotated. An AP pelvis is shown above. All of the following are independent risk factors for this current condition after having a total hip arthroplasty EXCEPT?
.
A- Post traumatic osteoarthritis of the hip
B- A female gender
C- #Osteonecrosis of the hip
D- Inflammatory arthritis
E- Age >70 years
.
.
.
.
.
.
SOURCE- Berry DJ, J Bone Joint Surg Am. 2004 ; Answer- A.
.
 The patient has a dislocated THA.
.
A closed reduction in the ER is usually possible about 2/3rds of the time. The patient may need a surgical revision of their THA if they have had 2 dislocations. Other reasons might be if there is #polyethylene wear or malalignment (XR shows that there is 1- vertical acetabular component or 2- acetabular retroversion which is the is also a common reason hardware failure). .
#Arthroplasty #hipsurgery #hipReplacement #THAdislocation .
#Ortho #Orthopedic #Orthopaedic #AAOS2030 #Residency  #medicalEducation #Orthotrauma  #hildoctor #evidencebasedmedicine #RadiologyResidency #bonedoctor #orthogrind #medschoolgrind #premed #hipSurgery #periprosthetichipfracture #hiparthritis #revisionTHA #VancouverClassification
  • A 71 year-old mechanic with a Total Hip Arthroplasty ( #THA) four years prior comes to the ER with acute hip pain after tying his shoes an hour ago. He can not ambulate and thigh is internally rotated. An AP pelvis is shown above. All of the following are independent risk factors for this current condition after having a total hip arthroplasty EXCEPT?
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    A- Post traumatic osteoarthritis of the hip
    B- A female gender
    C- #Osteonecrosis of the hip
    D- Inflammatory arthritis
    E- Age >70 years
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    SOURCE- Berry DJ, J Bone Joint Surg Am. 2004 ; Answer- A.
    .
    The patient has a dislocated THA.
    .
    A closed reduction in the ER is usually possible about 2/3rds of the time. The patient may need a surgical revision of their THA if they have had 2 dislocations. Other reasons might be if there is #polyethylene wear or malalignment (XR shows that there is 1- vertical acetabular component or 2- acetabular retroversion which is the is also a common reason hardware failure). .
    #Arthroplasty #hipsurgery #hipReplacement #THAdislocation .
    #Ortho #Orthopedic #Orthopaedic #AAOS2030 #Residency #medicalEducation #Orthotrauma #hildoctor #evidencebasedmedicine #RadiologyResidency #bonedoctor #orthogrind #medschoolgrind #premed #hipSurgery #periprosthetichipfracture #hiparthritis #revisionTHA #VancouverClassification

  •  224  15  28 March, 2020

Top #radiologyresidency Posts

  • As I take a few moments this morning to reflect on a couple things, I find myself banging my head against the table (figuratively) because I'm supposed to be relaxing on my off days and I don't find myself doing so. I spent a few hours yesterday working on talks, some future IG posts, and my website. Today I've already worked on my talks and a few posts for you all for the upcoming week. I did relax a bit yesterday, though, as I went to a Bluegrass music "festival" and had a lovely evening with my wife playing hangman while drinking sangria at a Mexican restaurant. I will fully admit that I don't NEED anymore money than what I already earn so it's not that. I'm very fortunate in that regard that "I made it". But there seems to be something more that I can't put my finger on and at times I struggle with. I end up ruining other things in the process. #firstworldproblems #medstudent #medicalschool #medicalstudent #intern #internship #resident #residency #imresident #surgeryresident #imresidency #surgeryresidency #radsresident #radiologyresident #radsresidency #radiologyresidency #ms1 #ms2 #ms3 #ms4 #pgy1 #pgy2 #pgy3 #pgy4 #pgy5 #fellowship #pccm #pedsresidency #obgynresident #familymedicineresidency
  • As I take a few moments this morning to reflect on a couple things, I find myself banging my head against the table (figuratively) because I'm supposed to be relaxing on my off days and I don't find myself doing so. I spent a few hours yesterday working on talks, some future IG posts, and my website. Today I've already worked on my talks and a few posts for you all for the upcoming week. I did relax a bit yesterday, though, as I went to a Bluegrass music "festival" and had a lovely evening with my wife playing hangman while drinking sangria at a Mexican restaurant. I will fully admit that I don't NEED anymore money than what I already earn so it's not that. I'm very fortunate in that regard that "I made it". But there seems to be something more that I can't put my finger on and at times I struggle with. I end up ruining other things in the process. #firstworldproblems #medstudent #medicalschool #medicalstudent #intern #internship #resident #residency #imresident #surgeryresident #imresidency #surgeryresidency #radsresident #radiologyresident #radsresidency #radiologyresidency #ms1 #ms2 #ms3 #ms4 #pgy1 #pgy2 #pgy3 #pgy4 #pgy5 #fellowship #pccm #pedsresidency #obgynresident #familymedicineresidency

  •  551  34  21 July, 2019
  • (Türkçe metin alttadır)
The zebra stripe sign occurs where children with osteogenesis imperfecta have been treated with cyclical bisphosphonate therapy, e.g. pamidronate.When the drug is delivered in cycles, dense bone is formed while treatment is being given. This results in dense stripes across the metaphyses of bones which can be visualized radiographically.
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Zebra şerit işareti osteogenezis imperfekta olan çocukların tedavi sürecinde  meydana gelir. Tekrarlayan bifosfonat tedavisi sırasında , yoğun kemik oluşumu izlenir.  Bu, radyografik olarak görselleştirilebilen kemiklerin metafizleri boyunca yoğun çizgilerle sonuçlanır. .
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. .#radiological #radiologycases #radiologystudent #radiology #radiolog #radiologist #radyoloji #radiologyclub #radiologyteam #radiologie #radiologyresidency #radiologic #radiologylearning #radiologyassistant #radiologi #radiologia #radiologyresident #radiologytech #radiologos #radyolog #globalrad #medicalassistant #medicalstudents #tıpöğrencisi #tıpöğrencileri #physiciansassistant #physician
  • (Türkçe metin alttadır)
    The zebra stripe sign occurs where children with osteogenesis imperfecta have been treated with cyclical bisphosphonate therapy, e.g. pamidronate.When the drug is delivered in cycles, dense bone is formed while treatment is being given. This results in dense stripes across the metaphyses of bones which can be visualized radiographically.
    .
    .

    Zebra şerit işareti osteogenezis imperfekta olan çocukların tedavi sürecinde meydana gelir. Tekrarlayan bifosfonat tedavisi sırasında , yoğun kemik oluşumu izlenir.  Bu, radyografik olarak görselleştirilebilen kemiklerin metafizleri boyunca yoğun çizgilerle sonuçlanır. .
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    .
    .
    .
    . . #radiological #radiologycases #radiologystudent #radiology #radiolog #radiologist #radyoloji #radiologyclub #radiologyteam #radiologie #radiologyresidency #radiologic #radiologylearning #radiologyassistant #radiologi #radiologia #radiologyresident #radiologytech #radiologos #radyolog #globalrad #medicalassistant #medicalstudents #tıpöğrencisi #tıpöğrencileri #physiciansassistant #physician

  •  1,465  13  16 September, 2019
  • That's deep. 🤔
  • That's deep. 🤔

  •  252  11  18 September, 2017