OSTEO-ARTICULAR SYSTEM

Bony structure
Gross section
photographic image of
proximal part of the
femur
X-ray image of the
same gross section

OSTEO-ARTICULAR SYSTEM

Distribution of lines of
force in the region of
femoral neck

Definition:

Classification of fracture:

Complete
By mechanism;
By number
By direction of fractures line

Incomplete
By mechanism;

Types of fracture: by
mechanism

Force fracture
Stress fracture
Direct fracture
Indirect fracture
Gunshot fracture
Pathological fracture

Gunshot fracture

Uncommon fractures
Stress and pathologic
etiologies

Presentation material for educational purposes only.

All rights reserved. 1999 URMC Radiology.

13 / 30

Types of fracture: by
number:

Unique
Multiple
Communited
Concurrent

Unique (simple) fracture

Multiple fracture = more

than one line of fracture

Concurrent
fracture

Complete fracture
Types of fracture: by
direction

OSTEO-ARTICULAR SYSTEM

Symptom of fracture line of fracture

a. Transversal
b. Oblic
c. Longitudinal

d. T-shaped
e. V-shaped

Imaging semiology of
fractures:

Fractures trajectory

Displacement of fractured fragments

OSTEO-ARTICULAR SYSTEM

Symptom of fracture displacement of fragments

a. Lateral
b. Longitudinal by
sliding
c. Longitudinal with
elongated extremity

d. Longitudinal by
interlocking
e. Angular
f. Rotation

Fracture Rx vs CT

Mandible Fracture

Mandible fractures are due to direct trauma. Most are comminuted

and typically involve both sides of the mandible

Spine Fractures
Oblique fracture of a lower cervical
spinous process,
commonly C7.
It results from hyperflexion, commonly from
shoveling snow.

Compression Fracture
Compression fractures of the spine are
common in elderly and osteoporotic
patients. They result from anterior or
lateral flexion. The typical appearance
is loss of height of the anterior aspect
of the vertebral body with preservation
of the posterior elements and generally
the posterior aspect of the vertebral body.
.

Pathological Fracture Humerus

Pathologic fractures result from an
underlying abnormality of the bone,
usually either from a primary bone
tumor or from metastatic disease.
However, pathologic fractures may
result from metabolic conditions as
well. A pathologic fracture results
when normal stress is placed onto
abnormal bone.

Greenstick Fracture
The greenstick fracture results from
direct trauma. There is an incomplete
fracture of a long bone (radius or ulna)
with cortical disruption on one side and
deformity on the other, resulting in
bowing of the bone.

Boxers Fracture
So named because of the common
occurrence in prizefighters, the
fracture involves the distal
metacarpal neck, usually of digit
five. The distal fracture fragment
is volarly angulated and may be
externally rotated. The injury
results from direct trauma to the
hand.

OSTEO-ARTICULAR SYSTEM

Radiograph of the femur

Shortening of the bone
by sliding of the
fragments

Imaging semiology of luxation

(dislocation)

Dislocations

Posterior
elbow

OSTEO-ARTICULAR SYSTEM

Radiograph of the
elbow
Changes in correlation
of articular surfaces
(displacement)

Imaging diagnosis of osteoarticular

pathology

Changes in shape and dimensions

1. Bone atrophy / hypertrophy
2. Bone inflation
3. Bone deformation
Changes of structure
1. Osteoporosis
2. Osteosclerosis
3. Destruction
4. Osteonecrosis
5. Osteolysis
Changes in periosteum
1. Periostosis
2. periostitis
Changes in soft tissues

Changes in shape and dimensions

Arched

Bony deformity
Angular

S-shaped

OSTEO-ARTICULAR SYSTEM

Bone atrophy
Eccentric
Concentric

OSTEO-ARTICULAR SYSTEM

Radiograph of the leg

Bone atrophy by
compression

OSTEO-ARTICULAR SYSTEM

X-ray of the femur

Blown bone (bone
inflation)

Changes of the contours

X-ray of the
femur
Thickening of the
bone
(hyperostosis=
hypertrophy)
a. Uniform
b. Unilateral

OSTEO-ARTICULAR SYSTEM

Changes of structure

Osteoporosis
Normal

Spongiose bone

Compact bone

OSTEO-ARTICULAR SYSTEM

X-ray of lumbar part of spine

OSTEO-ARTICULAR SYSTEM

X-ray of the knee

Hypertrophic
osteoporosis

Ankilosis

OSTEO-ARTICULAR SYSTEM

Osteosclerosis
Normal

Spongiose bone

Compact bone

OSTEO-ARTICULAR SYSTEM

X-ray of the leg. Osteosclerosis.

Focal sclerosis
Diffuse sclerosis

OSTEO-ARTICULAR SYSTEM

X-ray of the femur

Osteodestruction in
osteomyelitis

OSTEO-ARTICULAR SYSTEM

X-ray of the foot

Osteodestruction in tuberculosis osteitis

OSTEO-ARTICULAR SYSTEM

X-ray of the leg

Osteodestruction in
osteogenic sarcoma

OSTEO-ARTICULAR SYSTEM

X-ray of the leg

Osteodestruction in
metastasis

OSTEO-ARTICULAR SYSTEM

X-ray of the arm

Osteodestruction in
solitary bony cyst

OSTEO-ARTICULAR SYSTEM

X-ray of the forearm

Osteodestruction in giant
cell tumor of the bone

OSTEO-ARTICULAR SYSTEM

X-ray of the leg

Osteodestruction in giant
cell tumor of the bone

OSTEO-ARTICULAR SYSTEM

X-ray of the foot fingers

Osteolysis of the falangs

OSTEO-ARTICULAR SYSTEM

X-ray of the elbow

Osteolysis of the articular
ends

OSTEO-ARTICULAR SYSTEM

X-ray of the knee

Spongiose sequestrum

OSTEO-ARTICULAR SYSTEM

X-ray of the femur

Cortical sequestrum

OSTEO-ARTICULAR SYSTEM

Localization of sequestrum

Intraosseous
(in cavity)

Penetretion

Extraosseous

Changes in soft tissues

The options are many such as:
Gas in the soft tissues - a sign of an open
fracture or gas gangrene
calcification of various nature
Increase and decrease volume
The presence of foreign bodies

Calcification of various nature

Gas in the soft tissues

The presence of foreign bodies

Increase and decrease

volume

OSTEO-ARTICULAR SYSTEM

X-ray of the femur

Intraosseous localization
of the sequestrum

OSTEO-ARTICULAR SYSTEM

X-ray of the leg

Linear periostosis

OSTEO-ARTICULAR SYSTEM

X-ray of the femur

Stratified periostosis

OSTEO-ARTICULAR SYSTEM

X-ray of the femur

Fringe-shaped periostosis

OSTEO-ARTICULAR SYSTEM

X-ray of the femur

Ruche-shaped periostosis

OSTEO-ARTICULAR SYSTEM

X-ray of the leg

Acicular periostosis

Articular changes
X-ray of the knee
Thinning of the radiological articular space

Uniform

Non-uniform

OSTEO-ARTICULAR SYSTEM

X-ray of the pelvis

Thickening of the radiological articular space on

right in osteochondropathy

OSTEO-ARTICULAR SYSTEM

Thickening of the
radiological articular
space by destruction of
articular ends.

OSTEO-ARTICULAR SYSTEM

X-ray of the knee

Subchondral plate
sclerosis

OSTEO-ARTICULAR SYSTEM

X-ray of the shoulder

Osteophytosis

OSTEO-ARTICULAR SYSTEM

X-ray of the
coxofemoral joint
Arthrosis deformans

OSTEO-ARTICULAR SYSTEM

Radiograph of the
elbow
Changes in correlation
of articular surfaces
(displacement)