Posts

Teenager who cannot move their left shoulder after being pushed into a metal beam

Radiograph of anterior shoulder dislocation with Hills-Sachs lesion
AP (upper left) and axillary (above right) radiographs of the left shoulder show the left humeral head to be displaced anteriorly and medially in relation to the glenoid fossa. Post-reduction AP radiograph of the left shoulder (below) shows a defect in the posterolateral aspect of the humeral head.

The diagnosis was an anterior shoulder dislocation with a Hills-Sachs lesion post reduction.

School ager with ankle pain after a fall

Radiograph and CT of triplane fracture
AP (left upper) and lateral (right upper) radiographs of the ankle show a sagittal fracture through the tibial epiphysis, an axial fracture through the physis, and a coronal fracture through the tibial metaphysis. This is better demonstrated on the coronal (lower left) and sagittal (lower right) CT 2D reconstructions without contrast of the ankle.

The diagnosis was a triplane fracture (Salter-Harris Type III fracture).

Teenager with pelvic fracture from trauma who cannot void

VCUG and RUG of urethral transection
AP (upper left) and oblique (upper right) images from a voiding cystourethrogram with the bladder filled through a suprapubic catheter shows extravasation of contrast into the base of the penis when the patient attempts to void. Oblique image from a retrograde urethrogram (below) shows an inability to fill the urethra completely during retrograde injection.

The diagnosis was urethral transection confirmed at cystoscopy.

Preschooler with colicky abdominal pain

US of pancreatitis caused by pancreatic duct stone
Transverse US of the pancreatic head (above) shows just to the right of midline a round echogenic lesion with posterior shadowing in the center of the pancreatic head while transverse US of the pancreatic body (below) shows a dilated pancreatic duct throughout the body of the pancreas.

The diagnosis was a large stone in the pancreatic head portion of the pancreatic duct causing pancreatic duct obstruction and pancreatitis.