下肢影像解剖学.ppt

* * Post op total knee. * * * * Fractures through the medial and lateral malleoli * This is a CT scan showing you the fractures through the medial and lateral maleoli CT scans with sagittal reconstructions and 3-D volumn imaging * * * * * Note air in soft tissues on right due to bacterial growth. * Increased activity on bone scan supports osteomylitis in metatarsal * Urate crystals deposit and cause inflamation and erosion. * * Avascular Necrosis or AVN is caused by the loss of blood supply to a bone. It can happen anywhere but the most common place is in long bones such as the femur. It can be the result of a number of different things including injury or long term use of steriods. In this case it is the loss of blood supply to the femoral head from the artery to the head of the femur which comes from the posterior division of the obturator artery. Loss of blood supply to the femoral head can lead to collapse, fragmentation and arthritis * Mineral density is compared to young normal patients to assess for osteoporosis The angle of inclination is between the long axis of the femoral neck and the femoral shaft and it varies with age, sex, and development of the femor. The angle of inclination in a three year old child is 45 in an adult it is 126 and in an elderly individual the angle of inclination is 120. The angle is less in females because of the increased width between the acetabula and the greater obliquity of the shaft. The angle of inclination allows greater mobility of the femur at the hip joint because it places the head and neck more perpendicular to the acetabulum in the neutral postion. When the angle is decreased the condition is known as coxa vara (angle is less than 120) and when it is increased it is known as coxa valga (usually greater than 135). Coxa vara causes a mild shortening of the lower limb and limits passive abduction of the hip. * RF= Rectus Femoris VI= Vastus intermedius VL= Vastus Lateralis VM= Vastus Medialis FA= Femoral Artery FV= F