Sunday, 29 January 2012

Describing fractures on imaging

I'm still uneasy around x-rays. If it's not a clear cut case of whatever, it can feel like a magic-eye picture and whilst the Consultant's eyes bore into my temples I am left saying "uhhhhhhh".

One thing I picked up on the plastics rotation was describing fractures. Like so may things in medicine, and imaging in particular, there is a step-wise way to avoid missing out on any important details:

Always include the name of the patient, what kind of image it is, its orientation and when it was taken
Is it open or closed (does it fully penetrate the surrounding soft tissue)?
Is it transverse, oblique or spiral (exactly as the terms sound)?
Give the anatomical location of the bone involved and include the bone anatomy, too
Is there any joint (articular surface) involvement?
It is comminuted (more than two pieces)?

i.e. "This is a plain anterio-posterior radiograph of the right hand of John Smith, taken earlier today. There is a closed, oblique, mid-shaft fracture of the third metacarpal. There is no articular involvement and it is not comminuted"


  1. Wow! You have learned a lot on describing fractures through imaging. Nice job. :)

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