DASAR-DASAR RADIOLOGI MUSKULOSKELETAL

Ukuran: px

Mulai penontonan dengan halaman:

Download "DASAR-DASAR RADIOLOGI MUSKULOSKELETAL"

Yanti Sanjaya
6 tahun lalu
Tontonan:

1 DASAR-DASAR RADIOLOGI MUSKULOSKELETAL

2 Cara membaca foto MS A = Alignment B = Bone C = Celah sendi S = Soft tissue

3 ANATOMY TULANG DAN SENDI Pelajari anatomi tulang mulai dari skull sampai phalanx distal kaki

4 Articular cartilage 2. Subarticular of epiphyse 3. Epiphysis 4. Epiphyseal line 5. Metaphysis 6. Diaphysis 5. 6.

6 KELAINAN TULANG DAN SENDI 1. ANOMALI PERKEMBANGAN/KONGENITAL 2. INFEKSI 3. TRAUMA & FRAKTUR 4. PENYAKIT DEFISIENSI TULANG 5. PENYAKIT DISPLASIA TULANG 6. TUMOR TULANG 7. AVASCULAR NEKROSIS/ASEPTIK NEKROSIS 8. PENYAKIT DEGENERATIF SENDI/METABOLIK

7 FRAKTUR 4.1 Classification of fractures and dislocations General classifications a fracture is either a complete break in the continuity of a bone or an incomplete break or crack. fractures are subdivided according to their cause: 1. acute traumatic fractures 2. stress fractures 3. pathological fractures acute traumatic fractures are classified as: complete discontinuity between two or more bone fragments incomplete portion of cortex remains intact displaced space between margins of fracture causing deformity undisplaced bone fragments closely apposed with minimal deformity closed/simple no communication between fracture and skin surface open/compound wound extends from skin surface to fracture an open/compound fracture is liable to be contaminated and has a high risk of infection. descriptive terms used to indicate the shape or pattern of an acute fracture in the adult are (fig 4.1): 1. transverse fractures 2. oblique fractures 3. spiral fractures 4. comminuted fractures (2 or more fragments) 5. compression/crush fractures 6. depressed (in skull)

$Figure 4.1 Common fracture patterns.$

8 Figure 4.1 Common fracture patterns. (modified from Adams & Hamblen, Outline of Fractures, 10th ed, Churchill Livingstone 1992, with permission)

9 4.1.2 Dislocations a joint is dislocated (luxated) when its articular surfaces are wholly displaced one from the other, so that apposition between them is lost (fig 4.2). subluxation exists when the articular surfaces are partly displaced but retain some contact with each other. dislocation may occur in isolation or with a fracture (so-called fracture-dislocation) (fig 4.3).

$3 AP ankle showing a fracture-dislocation.$

10 Figure 4.2 Fifth finger showing dorsal dislocation of the proximal interphalangeal joint. Figure 4.3 AP ankle showing a fracture-dislocation. There is a spiral fracture of the distal fibula and medial subluxation of the distal tibia with respect to the top of the talus.

11 4.1.3 Fractures in children the pattern of bony injuries in the child are somewhat different to the adult as the skeleton is more elastic and less brittle. fractures in children are classified as (fig 4.4); complete greenstick fracture torus (buckle) fracture pipe fracture bowing injury infant s (toddler s) fracture epiphyseal/metaphyseal fractures avulsion injuries

12 Figure 4.4 Typical fracture patterns in children. (modified from Lee Rogers Radiology of Skeletal Trauma 2nd Ed, Churchill Livingstone 1992)

13 Figure 4.5 Child with a greenstick fracture of the radius.

14 4.3 Complications of fractures complications of fractures may be classified into intrinsic (related to the fracture itself ) and extrinsic (the result of associated injury). intrinsic complications include; delayed union and non-union malunion and shortening avascular necrosis infection degenerative joint disease extrinsic complications include; injury to adjacent vessels, nerves and tendons injury to viscera fat embolism (release of marrow fat to the lungs) reflex sympathetic dystrophy (Sudeck s atrophy)

15 GAMBARAN RADIOLOGI Osteomyelitis Osteoporosis diperlihatkan hr dari timbulnya gejala Infant dan Anak-anak metafise, soft tissue sweeling, involucrum timbul setelah tiga minggu Dewasa epifise, bone often remains sclerotic and irregular in outline CT Scan-----Terlihat local bone destruction pada fragmentasi dari densitas tulang

Osteomyelitis Plain radiographic findings in acute or subacute osteomyelitis are deep soft-tissue swelling, a periosteal reaction, cortical irregularity, and demineralization.

16 Osteomyelitis Plain radiographic findings in acute or subacute osteomyelitis are deep soft-tissue swelling, a periosteal reaction, cortical irregularity, and demineralization. The chronic phase of the disease is characterized by thick, irregular, sclerotic bone interspersed with radiolucencies, an elevated periosteum, and chronic draining sinuses.

17 Osteomyelitis Kronik clerosing osteomyelitis of the lower tibia. Sequestrum of the lower tibia

18 hronic osteomyelitis of the calcaneum. ir in the soft tissues. Cortex of the proximal phalanx of the hallux is irregular

19 Fraktur radius bagian distal a.fraktur Colles fr.radius bagian distal (sampai 1 mm dibagian distal) dengan angulasi ke posterior, dislokasi ke posterior dan deviasi fragmen distal ke radial b. Fraktur Smith Fr.radius bagian distal dengan angulasi atau dislokasi fragmen distal ke volar

$fracture$

20 Colles fracture

21 Foto PA: Foto Lateral: Fraktur radius bagian Displacement ke arah dorsal dan distal disertai fraktur angulasi radius bagian distal ke prosesus stiloid ulna arah proksimal

22 Smith s type fracture

23 Fraktur radius dan ulna a. Fr.Monteggia fr.ulna bagian proximal dengan dislokasi kaput radii b. Fr.Galeazzi fr.radius bagian distal dengan dislokasi ulna bagian distal

24 Fr. Galeazzi Fr. Monteggia

25 Fr. Galeazzi

26 Fr. Monteggia

dokumen-dokumen yang mirip

a. fraktur midshaft umum pada anak-anak maupun orang dewasa muda.

a. fraktur midshaft umum pada anak-anak maupun orang dewasa muda. 1. Klasifikasi patah tulang terbuka: menurut Gustilo Tipe I Luka kecil kurang dan 1 cm, terdapat sedikit kerusakan jaringan, tidak terdapat tanda-tanda trauma yang hebat pada jaringan lunak. Fraktur yang