The terminology, imaging findings, and treatment options of atraumatic fractures often overlap and are sometimes confusing. Bone is a living, dynamic organ, and these types of fractures are all caused by focal failure of the bone due to imbalances in the bone remodeling cycle. Although these diverse types of fractures (caused by repetitive stress, alteration in bone metabolism, and focal neoplasms, respectively) may at first glance appear to be unrelated, they actually share a common mechanism at the microstructural level. An atraumatic or minimally traumatic fracture is defined as a fracture caused by a relatively low-energy mechanism that normally would not be expected to cause a fracture. Atraumatic fractures elsewhere in the body also are used to illustrate key imaging features and treatment concepts.Ītraumatic fractures including stress fractures, atypical femoral fractures, and pathologic fractures are encountered frequently in the emergency department. Special attention is paid to fractures occurring in the proximal femur because the osseous macrostructure and mix of trabecular and cortical bone of the proximal femur can function as a convenient framework to understanding atraumatic fractures throughout the skeleton. Finally, imaging criteria to risk stratify an impending pathologic fracture at the site of an osseous neoplasm are discussed. In addition, imaging features are reviewed to help discriminate stress fractures from pathologic fractures in patients with challenging cases. For each type of fracture, the most clinically relevant imaging features that guide management by the multidisciplinary treatment team, including orthopedic surgeons, are reviewed. Next, the characteristic imaging findings of this diverse family of fractures is discussed. This framework is used to better convey the shared etiologies, key differences, and important imaging findings of these types of fractures. The basic biomechanics of normal bone is described, with an emphasis on the bone remodeling pathway. The terminology of atraumatic fractures is reviewed, with an emphasis on the distinctions and similarities of stress, atypical, and pathologic fractures. This article is a review of terminology, etiology, and key imaging features that affect management of atraumatic fractures including stress fractures, atypical femoral fractures, and pathologic fractures. Traumatic and atraumatic fractures are entities with distinct but often overlapping clinical manifestations, imaging findings, and management protocols.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |