Dislocation of Interphalangeal Joint of Thumb – Anteroposterior Xray

In contrast to other digits, thumb has only two phalanges. These are joined by interphalangeal joint.

Phalangeal dislocations are not very common.

The dislocation at this joint usually occurs due to a force causing hyperextension of the  joint.

The following xray is of a 22 years old man who sustained this injury after he struck his thumb inadvertantly with a moving object.

The dislocation was noted in the interphalangeal joint and was reduced closed.

The reduction was stable ans thumb has been immobilized in the plaster for two weeks.

Understanding Metastasis

Metastasis in Greek means displacement.

The term is used to denote the spread of a disease from one organ or part to another non-adjacent organ or part.

Malignant tumor cells and infections have the established capacity to metastasize. Until specified otherwise the term metastasis usually denotes malignant spread.

Why Does Metastasis occur?

Cancer cells can break away, leak, or spill from a primary tumor, enter lymphatic and blood vessels, circulate through the bloodstream, and be deposited within normal tissue elsewhere in the body.

Metastasis is one of three hallmarks of malignant tumors.

Different tumors have different capacity to metastasize.

When tumor cells metastasize, the new tumor is called a secondary or metastatic tumor. This is done to differentiate it from original source or primary tumor.

However, the cells of  new secondary tumor are similar to the primary tumor Read more

Fracture of Tibial Plateau – Anteroposterior Xray

Tibial plateau fractures are complex fracture involving articular surface of upper end tibia also called tibial plateau.
Because they are articular fractures in a weight bearing joint, it is important to treat this fractures with anatomical restoration of the joint congruity. Read more

Undisplaced Oblique Fracture of Lower Tibia – Anteroposterior View Xray

Oblique fractures are the fracture at an angle to transverse axis of the bone and extend into two planes. Oblique fractures are result of an indirect trauma.

Following xray is of 47 years old male who met with trauma when he was traveling on the bike. The xray reveals fractured tibia in an oblique fashion and comminution of fracture was visible.

The fracture has been successfully treated in above knee plaster cast.

Conditions That Could Be Mistaken As Scapular Fractures

There could be times when doubts arise in interpretation of history and xrays. Following entities may be considered in differentials of scapular fractures

Epiphyseal Lines
An ossification pattern of the scapula should be known to avoid this confusion. At birth, the body and spine of scapula form one ossified mass, with the coracoid, acromion, glenoid, and inferior angle all being cartilaginous.

At 3 to 18 months, a center of ossification,  appears at the mid-coracoid.

At 7 to 10 years, the coracoid base, including the upper third of the glenoid, appears.Sometimes called a subcoracoid bone and it joins the rest of the coracoid at 14 to 16 years. Read more

What Is Chondrocalcinosis?

Chondrocalcinosis is another name for Calcium pyrophosphate dihydrate disease, a rheumatologic disorder with varied clinical manifestations due to precipitation of calcium pyrophosphate dihydrate crystals in the connective tissues.

Its alternative names specify clinical or radiographic findings.

Pseudogout refers to the clinically evident acute synovitis with red, tender, and swollen joints that may resemble arthritis of gout.

Chondrocalcinosis, refers to the radiographic evidence of calcification in hyaline and/or fibrocartilage.
It is also called Pyrophosphate arthropathy. The knee joint is the most commonly affected.

List of Causes Of Back Pain

There are more than 400 conditions that can cause back pain. Instead of  providing comprehensive list, I have divided the conditions into different groups creating an overview.

Contrary to general belief, the bcak pain does not always originate from spine and vertebrae. Backpain may originate in visceral problems too.

Here are the major condtions that can cause backpain.

Mechanical Causes

• Apophyseal osteoarthritis
• Diffuse idiopathic skeletal hyperostosis
• Degenerative discs
• Scheuermann’s kyphosis
• Spinal disc herniation (slipped disc)
• Spinal stenosis
• Spondylolisthesis and other congenital abnormalities
• Leg length difference
• Restricted hip motion
• Misaligned pelvis – pelvic obliquity

Inflammatory Causes

• Seronegative spondylarthritides – for example ankylosing spondylitis)
• Rheumatoid arthritis

Infection

Epidural abscess or vertebral osteomyelitis

Neoplastic Causes

• Bone tumors (primary or metastatic)
• Intradural spinal tumors

Metabolic Causes:

• Osteoporotic fractures
• Osteomalacia
• Ochronosis
• Chondrocalcinosis
• Paget’s disease

Referred pain:

• Pelvic/abdominal disease

What Is Pars Interarticularis?

The Pars Interarticularis is a special region of the lamina between the superior and inferior articular processes.

The pars interarticularis,  pars for short, is the part of vertebra located between the inferior and superior articular processes of the facet joint.

This is weakest part of the lamina and a fracture or congenital anomaly of the pars may result in a Spondylolisthesis.

Xray of Fracture Lateral Condyle In Two Years Old Child

Fracture of lateral condyle are very common fracture in children. lateral condyle is part of the humerus bone that projects on outer astect of lower part of arm just above the level of flexor crease of the elbow (cubital fossa).

Most of the undisplaced  fractures can be managed conservatively. The surgery is required in cases which have displacement of the fragment more than 2mm or the fragment is rotated.

Read more

What Is Spondylosis?

Spondylosis refers to degenerative arthritis of the joints between the  vertebrae and/or neural foraminae. The interfacetal joints are not included in this term.

It is a common caus eo f back pain and if it is very severe can cause pressure on adjacent roots resulting in  sensory and/or motor problems, such as pain, paresthesia, or muscle weakness in the limbs.

When the space between two adjacent vertebrae narrows, compression of a nerve root emerging from the spinal cord may result in radiculopathy.  Read more

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