Discover and read the best of Twitter Threads about #orthorad
Most recents (12)
#Wetread Case 17
Hx: Wrist pain
Professionally appropriate gif responses only please. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #MSKRad #orthorad
Social media breaks are a good thing!😁
Hx: Wrist pain
Professionally appropriate gif responses only please. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #MSKRad #orthorad
Social media breaks are a good thing!😁
#Wetread Case 18 Answer: Trans-scaphoid Perilunate dislocation
-lunate still "normal" position while other carpal bones dislocate dorsally
++ assoc scaphoid fx! ⭐️⭐️ (count the proximal row 😁)
#FOAMrad #FOAMed #mskrad #errad #orthorad
-lunate still "normal" position while other carpal bones dislocate dorsally
++ assoc scaphoid fx! ⭐️⭐️ (count the proximal row 😁)
#FOAMrad #FOAMed #mskrad #errad #orthorad
Perilunate Dislocation:
Mechanism: high-energy trauma (MVA) or FOOSH (fall on outstretched hand)
Injury: torn radioscaphoid, scapholunate & lunotriquetral ligaments
👀 for the scaphoid fx!
Mechanism: high-energy trauma (MVA) or FOOSH (fall on outstretched hand)
Injury: torn radioscaphoid, scapholunate & lunotriquetral ligaments
👀 for the scaphoid fx!
#WetreadCoW Case 12
Hx: heel pain
Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Hx: heel pain
Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
#WetreadCoW Case 12 Answer: Haglund's Syndrome
Haglund's deformity= post-sup calcaneal spur (red)="pump bump"
Haglund's syndrome= deformity +Kager's fat pad edema (blue)+thick Achilles @ insertion & retroAchilles bursitis (green) #FOAMrad #FOAMed #radres #mskrad #orthorad
Haglund's deformity= post-sup calcaneal spur (red)="pump bump"
Haglund's syndrome= deformity +Kager's fat pad edema (blue)+thick Achilles @ insertion & retroAchilles bursitis (green) #FOAMrad #FOAMed #radres #mskrad #orthorad
Haglund's deformity/syndrome is assoc w use of rigid heel shoes, ex high heels (aka "pumps")➡️ irritation @ Achilles insertion & retroAchilles bursitis➡️ deformity+ edema+pain
US & MR show same thing!
Deformity(spur) alone ❌=symptoms (like plantar spur ❌=plantar fasciitis sx)
US & MR show same thing!
Deformity(spur) alone ❌=symptoms (like plantar spur ❌=plantar fasciitis sx)
#WetreadCoW Case 10
Hx: trauma survey exam. Fall, pain
Dx? Anything else you may want to consider given the history?
Please answer with professionally appropriate gif responses only. No spoilers. #FOAMrad #FOAMed #radres #errad #orthorad #MSKRad
Hx: trauma survey exam. Fall, pain
Dx? Anything else you may want to consider given the history?
Please answer with professionally appropriate gif responses only. No spoilers. #FOAMrad #FOAMed #radres #errad #orthorad #MSKRad
#WetreadCoW Case 10 Answer: Ankylosing Spondylitis
-fused SI jts
-fused pubic symphysis
- interspinous ligament ossification = "dagger spine"
-fused Lspine?
⭐️Need to look for spine fx!
Too easy? or maybe everyone is distracted by #ASER2020
#FOAMed #radres #mskrad #orthorad
-fused SI jts
-fused pubic symphysis
- interspinous ligament ossification = "dagger spine"
-fused Lspine?
⭐️Need to look for spine fx!
Too easy? or maybe everyone is distracted by #ASER2020
#FOAMed #radres #mskrad #orthorad
Ank Spon:
-seroneg spondyloarthropathy (neg Rheum factor) ➡️ fusion of the spine, SI jts, pubic symphsysis, and sometimes other jts
- assoc w HLA B27 gene
-M>F
-usually presents 3rd-4th decade
-trt: NSAIDS, motion/exercise, TNF-alpha blockers
-seroneg spondyloarthropathy (neg Rheum factor) ➡️ fusion of the spine, SI jts, pubic symphsysis, and sometimes other jts
- assoc w HLA B27 gene
-M>F
-usually presents 3rd-4th decade
-trt: NSAIDS, motion/exercise, TNF-alpha blockers
#WetreadCow Case 7
Hx: chest pain
Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #chestrad @thoracicrad @chestcases @TanMohammedMD
Hx: chest pain
Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #chestrad @thoracicrad @chestcases @TanMohammedMD
#WetreadCow Answer: Sprengel's Deformity
-M/C congenital abnl of the shoulder
-Failure of ⬇️ scapula (starts mid-cervical)
-often part of Klippel-Feil Deformity (cervical vert fusion)
-shoulder asymmetry w ⬇️ ABduction
#FOAMed #radres #chestrad #chestcases #orthorad
-M/C congenital abnl of the shoulder
-Failure of ⬇️ scapula (starts mid-cervical)
-often part of Klippel-Feil Deformity (cervical vert fusion)
-shoulder asymmetry w ⬇️ ABduction
#FOAMed #radres #chestrad #chestcases #orthorad
Sprengel's Imaging:
- ⬆️ (blue arrows) and ↪️(red arrow) scapula so inf tip points to spine (? smaller)
- Uni- or Bi- lateral
-👀 for bony omovertebral bone (bony or fibrous scapulo-vertebral connection - usually C4-C7) - up to 50%
-👀 for rib/spine abnl (green arrows) (K-F)
- ⬆️ (blue arrows) and ↪️(red arrow) scapula so inf tip points to spine (? smaller)
- Uni- or Bi- lateral
-👀 for bony omovertebral bone (bony or fibrous scapulo-vertebral connection - usually C4-C7) - up to 50%
-👀 for rib/spine abnl (green arrows) (K-F)
#WetreadCoW Case 2
Hx: Fall, pain
Anyone know my name?
Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Hx: Fall, pain
Anyone know my name?
Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
#WetreadCow Answer: Barton Fracture
Distal radial fx but only involves dorsal aspect of the distal radius (volar aspect is intact). Radial styloid ok on oblique?🤔
Barton fx=shear fx of dorsal distal radius
Shear off volar aspect=reverse Barton fx
#mskrad #orthorad #FOAMrad
Distal radial fx but only involves dorsal aspect of the distal radius (volar aspect is intact). Radial styloid ok on oblique?🤔
Barton fx=shear fx of dorsal distal radius
Shear off volar aspect=reverse Barton fx
#mskrad #orthorad #FOAMrad
This fx is not too displaced, but as the fx fragment displaces more, the carpal bones often dislocate with it. If we cone in tightly we can see the scaphoid/lunate are starting to migrate with the dorsal fragment
W/o proper trt, this can cause long term wrist pain/instability
W/o proper trt, this can cause long term wrist pain/instability
Wetread Summer Series Case 8
Hx: shoulder pain
Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #orthorad #MSKrad
Hx: shoulder pain
Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #orthorad #MSKrad
#WetreadCow SS Case 8
Answer: Septic joint + osteomyelitis (humerus + glenoid)
+RTC tear or two on MRI 😮
-Cortical destruction w/ ⬆️⬆️osteopenia
-large jt effusion
- ⬆️ soft tissue swelling
These go bad VERY fast! Aspiration is key!
#FOAMrad #radres #errad #orthorad #MSKrad
Answer: Septic joint + osteomyelitis (humerus + glenoid)
+RTC tear or two on MRI 😮
-Cortical destruction w/ ⬆️⬆️osteopenia
-large jt effusion
- ⬆️ soft tissue swelling
These go bad VERY fast! Aspiration is key!
#FOAMrad #radres #errad #orthorad #MSKrad
This was literally a Friday 5PM walking out the door case. To this day it reminds me:
1) Provided Hx can be useless (your 👀 >> indication)
2) Cortex, Cortex, Cortex - examine all the cortical margins
3) Soft tissues are your friend!
4) Beware first and last case of the day 😉
1) Provided Hx can be useless (your 👀 >> indication)
2) Cortex, Cortex, Cortex - examine all the cortical margins
3) Soft tissues are your friend!
4) Beware first and last case of the day 😉
Wetread SS Case 4
Hx: hip dislocation
Initial and post reduction films. Thoughts? 🤔 There may be a CT coming 😉
Professionally appropriate gif responses only. No spoilers! wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #MSKRad
Hx: hip dislocation
Initial and post reduction films. Thoughts? 🤔 There may be a CT coming 😉
Professionally appropriate gif responses only. No spoilers! wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #MSKRad
@AdamSingerMD @StefanTigges @ER_Rad_Hanna @RyanBPetersonMD Pt still had pain and limited ROM so CT was ordered. Anything wrong here?
#WetreadCow Answer: dislocated arthroplasty liner
Femoral head component does not sit centrally in the acetabular component because the radiolucent liner has dislocated into a communicating fluid collection (ie circular lucency lateral to troch!)#FOAMed #radres #MSKrad #orthorad
Femoral head component does not sit centrally in the acetabular component because the radiolucent liner has dislocated into a communicating fluid collection (ie circular lucency lateral to troch!)#FOAMed #radres #MSKrad #orthorad
Wetread Case 40
Hx: elbow swelling.
Diagnosis(es)?
Clinician inquires about aspiration. Thoughts?
Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Hx: elbow swelling.
Diagnosis(es)?
Clinician inquires about aspiration. Thoughts?
Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Wetread Case 40 Answer
Answer: Olecranon Bursitis secondary to Gout
We have focal mass-like soft tissue density posterior to the olecranon with o/w minimal soft tissue edema. Add on some soft tissue Ca+ and this is classic picture of gouty olecranon bursitis
Answer: Olecranon Bursitis secondary to Gout
We have focal mass-like soft tissue density posterior to the olecranon with o/w minimal soft tissue edema. Add on some soft tissue Ca+ and this is classic picture of gouty olecranon bursitis
Etiologies for olecranon bursitis:
-trauma
-repeated or continued pressure/irritation (aka “student’s", “baker’s” or Popeye elbow)
-infection
-inflammation (classically gout, although RA and CPPD as well)
-trauma
-repeated or continued pressure/irritation (aka “student’s", “baker’s” or Popeye elbow)
-infection
-inflammation (classically gout, although RA and CPPD as well)
Wetread Case 36
Hx: Several weeks of worsening wrist pain
How specific can you be?
Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Hx: Several weeks of worsening wrist pain
How specific can you be?
Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Yeah! We have a lot of widened scapholunate distance references, aka:
Terry Thomas Sign
David Letterman Sign
Michael Strahan Sign
Madonna Sign
referring to their diastema (or increased gap between their front teeth)
Terry Thomas Sign
David Letterman Sign
Michael Strahan Sign
Madonna Sign
referring to their diastema (or increased gap between their front teeth)
Answer: Dorsal Intercalated Segment Instability (DISI)
Findings:
1) Widened scapholunate distance from full thickness tear
2) Abnormal scaphoid - old fx perhaps? (m/c carpal fx goes with prior injury) 🤔
3) Dorsal rotation of the lunate on the lateral exam
Findings:
1) Widened scapholunate distance from full thickness tear
2) Abnormal scaphoid - old fx perhaps? (m/c carpal fx goes with prior injury) 🤔
3) Dorsal rotation of the lunate on the lateral exam
Wetread Case 34
Hx: palpable mass (No X-rays. 🤷♂️)
Diagnosis? Any relevant medical history you can think of?
Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Hx: palpable mass (No X-rays. 🤷♂️)
Diagnosis? Any relevant medical history you can think of?
Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Answer: Calcinosis of Chronic Renal Failure (ie Secondary Tumoral Calcinosis)
Yes, Dialysis/renal failure is the key!
#WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Different patient:
Yes, Dialysis/renal failure is the key!
#WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Different patient:
True Tumoral Calcinosis (TC) is ususally reserved for the hereditary dysfunction of phosphate regulation yielding large, painless, periarticular Ca+.
Here we have the exact same finding except secondary to chronic renal failure, thus “secondary” or “uremic” tumoral calcinosis.
Here we have the exact same finding except secondary to chronic renal failure, thus “secondary” or “uremic” tumoral calcinosis.
Wetread Case 30
Hx: foot pain
How about something, anything outside of the chest 😂
Feel free to answer with professionally appropriate gif responses only. No spoilers.
wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad and no 🤔 or 🤭! 🤣
Hx: foot pain
How about something, anything outside of the chest 😂
Feel free to answer with professionally appropriate gif responses only. No spoilers.
wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad and no 🤔 or 🤭! 🤣
Answer: Intraosseous lipoma of the calcaneous
but I bet everyone knew that!
Classic appearance = a well circumscribed lytic lesion in the calcaneal body with central Ca++ (aka cockade sign)
but I bet everyone knew that!
Classic appearance = a well circumscribed lytic lesion in the calcaneal body with central Ca++ (aka cockade sign)
Whats a cockade?
= a rosette - a knot of ribbon rolled into a badge.
So central density surrounded by well circumscribed low density area
= a rosette - a knot of ribbon rolled into a badge.
So central density surrounded by well circumscribed low density area
Wetread Case 28
Hx: Trauma 3 weeks ago with new knee pain
Diagnosis? And be specific!
Feel free to answer with professionally appropriate gif responses only. No spoilers.
wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Hx: Trauma 3 weeks ago with new knee pain
Diagnosis? And be specific!
Feel free to answer with professionally appropriate gif responses only. No spoilers.
wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad
Answer: Pellegrini-Stieda Syndrome
Here's the X-ray and CT from 3 weeks ago.
New X-ray shows development of calcification/ossification near femoral attachment of MCL and the CT 3 wks ago shows thickening/injury to the MCL. This is all c/w the classic Pellegrini-Stieda lesion
Here's the X-ray and CT from 3 weeks ago.
New X-ray shows development of calcification/ossification near femoral attachment of MCL and the CT 3 wks ago shows thickening/injury to the MCL. This is all c/w the classic Pellegrini-Stieda lesion
So we have 2 entities:
1) Pellegrini-Stieda lesion = the post-traumatic calcification/ossification classically near the femoral attachment of the MCL
2) Pellegrini-Stieda Syndrome = Pain @ a developing P-S lesion. Typically seen about 3-6 wks post injury.
1) Pellegrini-Stieda lesion = the post-traumatic calcification/ossification classically near the femoral attachment of the MCL
2) Pellegrini-Stieda Syndrome = Pain @ a developing P-S lesion. Typically seen about 3-6 wks post injury.
