Skeletal trauma

It is indicated for the relief of pain and inflammation in osteoarthritis, rheumatoid arthritis, ankylosing spondylitis and musculo-skeletal trauma. 

Trauma is one of the most common reasons for a child s attendance in the emergency department. Plain radiographs may remain the primary imaging modality following suspected skeletal injury, but with the advent of first single detector CT (SDCT) and now multi-detector row CT (MDCT) scanners, the role of CT in skeletal trauma has continued to develop. 

With the advent of MDCT scanners, a continued increase in requests for CT examinations following skeletal trauma is foreseen. It is imperative that the radiologist scrutinises all such requests carefully and makes use of other imaging modalities, which do not involve ionising radiation, whenever possible. If a CT study is deemed necessary, then... 

Buckwalter KA, Farber JM (2004) Application of multidetector CT in skeletal trauma. Semin Musculoskelet Radiol 8 147-156... 

The effects of skeletal trauma may be simulated by normal anatomical variations during development, projection artefacts and overlap of adjacent structures. Secondary ossification centres or irregular sites of ossification that appear fragmented are often mistaken for traumatic injury. The mach effect is a physiological form of edge enhancement created when there is an abrupt change from light to dark (radio-opaque to radiolucent) or vice versa at a concave or convex interface of a subject. Its presence at the interface of structures can simulate a fracture line. Similarly, overlap of normal structures such as skin or soft tissue folds can produce an identical appearance (Fig. 7.1). 

Normal Anatomical Variants and Other Mimics of Skeletal Trauma... 

Accessory ossicles associated with bones in the wrist and hand can be mistaken for fracture fragments, but accessory ossicles are usually well corticated allowing them to be distinguished from fresh bony fragments resulting from recent skeletal trauma. Clinical correlation is necessary, including absence of tenderness over the area in question. 

It is important to understand the fracture patterns that alter with age. Initially radiographs will be obtained for skeletal trauma with MR imaging and computerised tomography (CT) being used as appropriate. 

Rogers LF (1992) The knee and shafts of the tibia and fibula. In Radiology of skeletal trauma. Churchill Livingstone, New York... 

Green E, Swiantkowski MF (eds) (1998) Skeletal trauma in children, 2 edn. WB Saunders,Philadelphia Hoerr NL, Pyle SI, Francis CC (1962) Radiographic atlas of the skeletal development of the foot and ankle. Charles Thomas, Springfield, 1962... 

This volume, dedicated to skeletal trauma in infants and children, is a very welcome addition to the list of titles on pediatric imaging published in the Medical Radiology series in recent years. 

The editors and authors of individual chapters are well known for their particular clinical expertise and skills in pediatric skeletal trauma. I would like to thank and congratulate them most sincerely for their superb efforts which have resulted in this outstanding volume. 

Grogan, B.F., Hsu, J.R., Skeletal Trauma Research Consortium, 2011. Volumetric muscle loss. J. Am. Acad. Orthop. Surg. 19 (Suppl. 1), S35—S37. 

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