Anterior shoulder dislocation

2. Anterior shoulder dislocation • Findings: • Inferomedial subcoracoid displacement of the humeral head • Too much overlap of humeral head and bony glenoid • Axillary view is diagnositic and shows Hill-Sachs and Bankhart lesions • ddx: • NONE! • This is an Aunt Minnie!

4. Posterior shoulder dislocation • Findings: • Lateral displacement of the humeral head • “Empty glenoid sign” • Axiallary and trans-scapular Y views are diagnostic • “Trough sign” and posterior bony glenoid impaction • ddx: • NONE! • This is an Aunt Minnie!

6. Sternoclavicular dislocation • Findings: • Asymmetric appearance of sternoclavicular joints – medial portion of left clavicle looks abnormal • Need to do CT to evaluate great vessels and mediastinum • ddx: • Occult fracture of sternum or medial clavicle

8. Trans-scaphoidperilunate dislocation • Findings: • Fracture of the radial styloid, scaphoid, and ulnar styloid • Posterior dislocation of the capitellum • ddx: • NONE! • This is an Aunt Minnie!

10. Lunate dislocation • Findings: • Disruption of proximal carpal row • “Pie-shaped lunate” • Lateral view is diagnostic • ddx: • NONE! • This is an Aunt Minnie!

12. Talar osteochondral fracture • Findings: • Cortical irregularity of the lateral talar dome with bony fragments in the lateral mortise and widening of the distal tibiofibular syndesmosis • Check for proximal fibula fracture • ddx: • NONE! • This is an Aunt Minnie!

14. Homolateral Lisfrancfracture-dislocation • Findings: • Lateral dislocation of 1st thru 5th metatarsals at the Lisfranc joints • types • divergent • homolateral • partial incongruity • ddx: • NONE! • This is an Aunt Minnie!

16. Diabetic Charcot foot &Lisfranc fracture dislocations • Findings: • Destruction, debris, dislocation, and increased density of Lisfranc joints • Pes planus • Vascular calcifications indicative of DM • ddx: • osteomyelitis

18. Nail bed injury • Findings: • Horizontal fracture at the base of the great toe distal phalanx • Consider this as an open fracture with a high incidence of osteomyelitis • ddx: • NONE! • This is an Aunt Minnie!

20. Pathologic fracture • Findings: • Lucent lesion in the medullary space of the distal humeral diaphysis with cortical scalloping and periosteal reaction • ddx: • NONE! • This is an Aunt Minnie!

22. Lymphoma • Findings: • Diffuse permeative lesion of the proximal femur • ddx: • Metastases • Multiple myeloma • Osteomyelitis • Langerhan’s cell histiocytosis (peds)

24. Ewings’s sarcoma • Findings: • “Sunburst” periosteal reaction of the distal fibular diaphysis • ddx: • Osteosarcoma • Osteomyelitis • Langerhan’s cell histiocytosis

26. Discitis/Osteomyelitis • Findings: • L4-5 disc space and adjacent endplate sclerosis and destruction • ~50% anterolisthesis and gibbus deformity • ddx: • NONE! • This is an Aunt Minnie!

28. Rheumatoid arthritis • Findings: • Joint space narrowing • “rat bite” marginal erosions • No new bone formation • Soft tissue swelling • ddx: • Gout • Septic arthritis • psoriasis

30. Right hip septic arthritis • Findings: • Increased distance form medial from medial femoral head to teardrop = teardrop distance • ddx: • Aseptic joint effusion • Synovitis • Hematoma

32. Hardware infection • Findings: • 2mm lucency surrounding fixation hardware and screws • ddx: • Hardware loosening

34. Necrotizing fasciitis • Findings: • Soft tissue swelling and gas overlying the wrist and proximal hand • Vascular Ca2+ = DM • ddx: • Post-traumatic soft tissue gas

36. Asymmetric SI fusion • Findings: • Right SI joint fusion • Symmetric hip joint narrowing • ddx: (asymmetric) • Reiter syndrome • Psoriatic arthritis • Infection (symmetric) • Inflammatory bowel dz • Ankylosing spondylitis

38. Symmertic sacroiliitis &Ulcerative colitis • Findings: • Symmetric SI joint erosion and subchondral sclerosis = sacroiliitis • Mildly dilated ahaustral ascending colon • ddx: • NONE! • This is an Aunt Minnie!

40. Gout • Findings: • Large erosions with overhanging margins at the great toe MTP joint • Dense periarticular swelling • Sparing of the joint space • ddx: • NONE! • This is an Aunt Minnie!

42. CPPD • Findings: • Bilateral wrist and 1st – 3rd MCP joint space narrowing • Small hook-like osteophytes of the MC heads • Chondrocalcinosis of the wrist • ddx: • hemochromotosis

44. Hyperparathyroidism &Acro-osteolysis • Findings: • Erosion and resorption of digital tufts • Osteopenia with coarse trabecula • Subperiosteal bone resorption along the radial side • ddx: (acro-osteolysis) • Frostbite / Electrical burn • Polyviny chloride exposure • Pyknodysostosis • Neuropathy • Psoriatic arthritis • Hajdu-Cheney syndrome

46. Renal osteodystrophy &Rugger jersey spine • Findings: • Trabecular rarefication within the central vertebral bodies and increased scleroisis of the endplates = “rugger jersey spine” • ddx: • NONE! • This is an Aunt Minnie!

48. Hyperparathyroidism &Brown tumor • Findings: • Round lucent lesion in the proximal great toe phalanyx • Osteopenia • Marginal erosions • Vascular Ca2+ = ESD • ddx: • Enchondroma • Fibrous dysplasia • Brodie’s abscess

50. Hyperparathyroidism &Dystrophic soft tissue Ca+ • Findings: • Abnormal soft tissue Ca2+ in the anterior pelvis • Vascular Ca2+ • ddx: • Tumoral calcification • Myositis ossificans progressiva