Thursday, August 25, 2011

Is this a fracture on the plain film?

There is this query which we all radiologists find in plain films in this era of MRIs and PETs and this section of ours is usually dealing with apparently innocuous questions like in this case “is this a fracture?” Professor Resident series by Dr MGK Murthy.

What is it?
There is vertical line across the metaphysis of 1st metatarsal with no significant soft tissue swelling or articular  abnormality

Is it fracture in view of history of injury ?
 No you can clearly see on invert image it is not identified and hence represents vessel

Any further imaging is needed?
No , we need to take radiological call  at this stage it is not fracture

 How to write  report?
There is vertical lucency seen across the middle of metaphysis of 1st Metatarsal  possibly representing  vessel with no soft tissue or joint involvement – represents vessel. However if there is local tenderness,  MRI / follow-up Xray after 2 weeks would help


Dr. Pankaj Nagori said...

Nice post sir. There is always a doubt with a fracture line like this but in future I would look into the inverted image and confirm it.
Thanks a lot for this post.

MGK Murthy said...

i am enthused by some one taking the cue , i am learning daily
the important thing is not to stop questioning=Einstein
iam lucky someone else keeps asking me questions
thx pankaj

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