Fracture Mimics DR MUHAMMAD BIN ZULFIQAR PGR III FCPS Services institute of Medical Sciences/ Services Hospital Lahore Special thanks to Learning Radio
Fracture Mimics
DR MUHAMMAD BIN ZULFIQARPGR III FCPS Services institute of Medical
Sciences/ Services Hospital Lahore
Special thanks to Learning Radiology
Accessory Ossicle• Multiple ossification
centers are common in epiphyses and aresmooth and well-corticated
Apophysis
• Apophysis of the 5th MT runs in alongitudinal direction; fractures areusually transverse
Normal Epiphyseal Plate
• Don't confuse the undulationsof the humeral epiphyseal platefor a fracture
Bipartite Patella
• Bipartite patella almost always affects the upper outer pole of patella; 57% are bilateral
Nutrient Channel (Canal)
• Nutrient channels or canals rundiagonally only in the cortices ofcertain bones
Normal Excrescence
• Radial spur is normal variantoccurring on the lateral aspect of the radius at the site of the physis
Normal Excresence
• This is a normal bonyexcresence from the scaphoid that can be mistaken for a fracture
Sesamoids
• Sesamoids are ossicles embedded in a tendon that aid in movement; they are common in the feet and hands
Skin Laceration
Air beneath lacerations may superimposeon the bone simulating fractures; look at multiple projections
Lack of Fusion
• Hyoid Bone fuse later in lifeusually by age 40; it is thereforecommon to see and unfused hyoid
Mach Lines
• "Mach Lines“ are optical illusions which produce a black line where none exists; they are common at the base of the dens
• Synchondrosis• 3 main temporary J oints in pelvis: ilio-pubic,
ischio-pubic and ilio-ischial; bilateral and usually symmetric
Costovertebral Junction
• Every rib attaches to the spine at the costo-vertebral junction; not to beconfused with a fracture
Multiple Ossification Centers
• The calcaneal apophysis frequently has multiple centers of ossification and appears denser than rest of calcaneus
Sesamoids
• There are almost always sesamoids of the thumb; they are well-corticated and smooth-edged, unlike fractures
Accessory Ossicle
• Os Trigonum-accessory ossicle just posterior to the talus normally found in 5-15% of people