Jasmin Fauteux August 25 th 2011 Objectives Review Indications The views The approach Fractures Cases Knee rules PDRs applicability has yet to be proven Pittsburgh Decision rule potentially more specific ID: 784538
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Slide1
Approach to the knee radiograph for bony injuries
Jasmin
Fauteux
August 25
th
2011
Slide2Objectives
Review:
Indications
The views
The approach
Fractures
Cases
Slide3Knee rules
Slide4PDR’s applicability has yet to be proven
Pittsburgh Decision rule potentially more specific
Slide5The views
Slide6Lateral
Slide7Anteroposterior
Slide8Obliques
Slide9Tunnel view
Slide10Skyline
Slide11The approach
Slide12S-ABC
Targeting your approach to look for suspected fracture
OR
Soft tissue
Alignment
Bone
Cartilage and joints
Slide13Soft tissue
Lipohemarthrosis
Effusion
Slide14Lipohemarthrosis
Slide15Effusion
May be caused by a bone injury in 53% of cases
Slide16Alignment
Condyle with plateau
Patellar alignment
Slide17Bone
Cortices
Trabecular pattern
Intra-articular bodies
Slide18Cartilages and joints
Patellofemoral
Femorotibial
Slide19Tibial plateau
Lipohemarthrosis
Oblique views
Low force required in osteoporosis
Slide2016% are missed by EP
Slide21Tibial plateau
Trabecular density
Widening of joint space
Lateral displacement
Slide22Schatzker classification
Slide23Segond’s fracture
Slide24Reverse Segond’s
Slide25Arcuate complex avulsion
Prox. Fibula
Horizontal
Posterolateral
Slide26Tibial spine
Children > Adults
ACL avulsion
Slide27Case 1
26yo M
Fell onto flexed knee
Isolated patellar pain
Slide28Case 2
62yo F
Twisted knee while moving
Walking with cane
Flexion to 60 degrees
Slide29Case 3
34yo M
Snowboarding
Painful lateral joint line
Slide30Case 4
33yo F
High intensity MVA
Painful prox.
f
ib
Slide31Thank you!
Thank you!
Slide32Bibliography
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imon LV, et al: The Pittsburgh Decision rule: triage nurse versus physician utilization in the emergency department.
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