By Louis Solomon, David Warwick, Selvadurai Nayagam
A accomplished advent to the sphere of orthopaedics and trauma.
summary: A complete advent to the sector of orthopaedics and trauma
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Additional info for Apley's system of orthopaedics and fractures
Diagnostic associations However carefully the individual x-ray features are observed, the diagnosis will not leap ready-made off the x-ray plate. Even a fracture is not always obvious. It is the pattern of abnormalities that counts: if you see one feature that is suggestive, look for others that are commonly associated. • Narrowing of the joint space + subchondral sclerosis and cysts + osteophytes = osteoarthritis. • Narrowing of the joint space + osteoporosis + periarticular erosions = inﬂammatory arthritis.
Other polyostotic lesions include ﬁbrous dysplasia, histiocyotis, multiple exostosis and Paget’s disease. With aggressive looking polyostotic (a) (b) (c) Orthopaedic diagnosis (a) lesions think of metastases (including myeloma and lymphoma) and also multifocal infection. By contrast, most primary tumours are monostotic. Localized change Focal abnormalities should be approached in the same way as one would conduct a clinical analysis of a soft tissue abnormality. Start describing the abnormality from the centre and move outwards.
C) Dyschondroplasia. (d) Congenital pseudarthrosis. (e) Syphilitic sabre tibia. (f) Osteogenesis imperfecta. vertebral alignment, then at the disc spaces, and then at each vertebra separately, moving from the body to the pedicles, the facet joints and ﬁnally the spinous appendages. For the pelvis, see if the shape is symmetrical with the bones in their normal positions, then look at the sacrum, the two innominate bones, the pubic rami and the ischial tuberosities, then the femoral heads and the upper ends of the femora, always comparing the two sides.
Apley's system of orthopaedics and fractures by Louis Solomon, David Warwick, Selvadurai Nayagam