醫學筆記匯整 ED Notes

Radial head dislocation

- Should be distinguished from a pulled elbow (Radial head subluxation)
X-ray : Malalignment of the radiocapitellar line is seen in the lateral projection.
Normally, the radiocapitellar line should always intersect the capitellum.

Radiocapitellar line : 
https://www.youtube.com/watch?v=mP2O-jRBeJU&feature=youtu.be

正確的 ~ 要從 Radial neck 畫線
 

第二張圖從 Shaft 開始畫是錯的

Radial Head Fracture 有時不明顯
要觀察 fat pad sign 
因為正常 lateral view 應該看不到 fat pad
當 intra-articular injury 出血
血液流到關節時會使滑液膜脹大而將脂肪墊擠出去
Fat pad sign 表示可能有關節內出血 (intra-articular hemorrhage)
最常與橈骨頭骨折有關
 

Shoulder Dislocation

- Most common joint dislocation
- Anterior (95%) > Posterior > Inferior
- 容易復發, 復發機會與第一次發生年齡最相關

- Anterior dislocation 就是明顯往前掉
- Posterior dislocation 易 misdiagnosis
   * 遭電擊病人或 Seizure 病人因肌肉劇烈收縮造成
   * 要有 True lateral view(Y-view) 或 CT scan
   * Light bulb sign (Humeral head internal rotation)

https://www.youtube.com/watch?v=Z9CO6Gd-23A&feature=youtu.be

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