RADIO 2

7/18/13

All sesamoids are accessory bones, but not accessory bones are sesamoids Accessory bones no rules !! Can be fragmented, b/l symmetrical or not, may be jagged or not, etc o Size, symmetry, fragmented/intact none of these defines a accessory bone OS TRIGONUM is a separate lateral process of the talus o best seen in lat view o Steidas process is when attached enlarged lateral post process of talus Fracture of a steidas process is called a shepards fracture o Steidas process can become shepards fracture OS PERONEUM located plamtarlateral to the cuboid thus medial oblique view is best o is sesamoid to the peroneus longus, so can be easily mistakened for a fractured cuboid OS VESALIANUM apophysis in the base of the fifth metatarsal, o Usually parallel to long axis of the 5th metatarsal o forms btwn 8-12 in girls, forms at age 14 in boys, o Avulsion fracture/Jones fractures are transverse Jones fractures are more distal transverse fractures Os calcanius secondarius distal anterior tuberosity of calcaneus and btwn navicular o Looks exactly like a cN coalition Have to differentiate from fractured coalition Or can be avulsion fracture of bifurcate ligament Os metatarseum = os intermetarsium can look like Mockensberg calcification of DPn,(the perforating branch) or fracture o If 2nd, 3rd or 4th interspace, can be MC too! Osteocongenity islens disease osteogenesis of base of 5th met Severes Disease symptomatic fragmented calcaneus apophysis = osteocongitity Plantar fasciitis > > Haglands deformity Os tibiale fx Plantarmedial, proximal to use LO view Accessory navicular use medialoblique view (more dorsomedial) o Notorious non-healer worst to have! Os tibiale more common in PT in ankle in old Colers disease aseptic necrosis of navicular o Normal variant not a true osteocongritity o Still limiting

Fragment does not equal fracture If kv too high decreased contrast so cant see toes! IP sesamoid in hallux a lot Fragmented apophysis If 1st and 2nd MT overlaps, is medial oblique view Os sub tibiale Mockenbergs Bc of equinous Rotation spiral fracture Most common etiology of bunion in kid due to hypermobility of 1st Midtarsal jt severe midtarsal pronation because of equinous Comminuted more than 1 piece Compound fracture = fracture broke to skin Jones fracture = distal to styloid, so is closer to 5th shaft vs base part