Mensuration of Elbow
Anterior Humeral line
Radiocapitellar line
Effusion of elbow, what will shown in fat pads
Anterior fat pad will displaced and show sail sign
Posterior fat pad will become elevated and visible
What will be shown in Abnormal Wrist Fat Pad
Abnormal pronator quadratus fat pad will be displaced and bowed
Normal will show a straight line
Principal Radiographic features for Osteo arthritis (OA)
- Asymmetrical joint-space narrowing
- Subchondral sclerosis of bone
- Marginal osteophytes
- Subchondral cysts
Erosive Osteoarthorosis common sites and radiographic sign
- Common at distal interphalangeal joint (DIP) and occasionally in 1st metacarpophalangeal joint (MCP)
- Common among postmenopausal women
- Bilateral symmetric distribution
Imaging sign: Gull wing
Typical hand deformities in rheumatoid arthritis
- Ulnar drift
- Knuckle subluxation (partial dislocation)
- Wrist subluxation
- Finger swan neck
- Finger boutonniere
- Z-shaped thumb
RA in Elbow what radiographic signs show?
- Prominent distal humerus, radial head and coronoid process erosions
- Positive fat pad sign (posteriorly)
RA in Hand and Wrist what clinical finding show
- Proximal distribution with wrist finding usually appearing first
- Fusiform swelling
- Periarticular osteopenia
- Ulnar deviation of phalanges (Late)
- Swan neck, Boutonniere, hitchhiker deformity due to tendon rupture (late)
Clinical features of Psoriatic Arthritis
- 20 to 50 years old
- nail changes (pitting,ridging, discoloration, loss of nail, thickening of skin
General radiologic features for Psoriatic arthritis
- Asymmetric distribution
- Soft tissue swelling
- Normal bone mineralization
- Erosions
- Fluffy periostitis
- Narrowed (late) or widened joint space (early)
Deformity in Psoriatic arthritis
- Pencil-in-cup deformity
- Opera glass hand
- Arthritis mutilans
Common Site for Gout
1st metatarsophalangeal joint (MTP)
Radiographic sign for gout in Elbow
- Erosions of olecranon and adjacent ulna
- Trophaceous involve of olecranon bursa leads to prominent mass on lateral view (Rising Sun)
Radiographic sign for gout in Wrist and hand
- Erosions, soft tissue swelling and misalignment
- Overhanging sign
- Erosion of the carpal (sporty carpal sign)
Most common fracture in elbow for children
Distal humerus, Supracondylar (60%)
distal fragment usually displaces posteriorly
What will show Proximal Radius Fracture in xray
Chisel fracture - Incomplete fracture of radial head that extends to center of articular surface
What is Monteggia’s Fracture
Fracture of Proximal ulna with dislocation of radius at proximal shaft
What is Galeazzi’s Fracture (reverse monteggia’s fracture)
Fracture of distal radial shaft with dislocation of distal radioulnar joint
What clinical finding for Nursemaid’s Elbow (pulled elbow)
- immediate pain; stuck in mid-pronation due to pain
- maintain supination to reduce the dislocation and ends pain
