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the spine, pelvis and complex foot

injuries

Queencia Editha Morin


406148027
Pembimbing,
d r. O k t i n a Ra c h m i , S p . Ra d

Abstract
Multislice CT (MSCT) adalah suatu pengembangan dari
CT Scan untuk dapat mendeteksi dengan cepat trauma
pada muskuloskeletal dengan waktu yang lebih singkat
dengan resolusi yang lebih tinggi.
Keutungan dari MSCT adalah multiplanar reconstruction
(MPRs) , 3D dan potongan yang lebih tipis, juga lebih
akurat pada potongan anatomi yang lebih kompleks
seperti vertebrae , pelvis dan cruris.
Laporan tentang trauma cervical & spine pada pasien
dengan trauma kepala sekitar 4 % - 8% di Amerika
Serikat. Sedangkan di Indonesia 52 % - 55 % pasien
mengalami trauma pada spine, pelvis dan foot.

Figure 1. (a) Plain lateral radiograph of the cervical spine. Only five vertebral
bodies are visualized. (b) Sagittal image showing fracture avulsion of the

Figure 2. (a) Sagittal plain radiograph of the cervical spine. There is an acute
kyphotic angulation at C6/7 and a fracture of C7 with anterior wedging due to
collapse of the superior endplate. There is a separated bone fragment from
the superior endplate of C7. The C6/7 disc space is widened posteriorly. No
other fractures were demonstrated on plain film. (b) Sagittal multislice CT

Figure 2. (c) Axial MSCT image of the fractured C7 vertebra showing


the retropulsed fragment posteriorly displaced into the canal. (d)
Sagittal MSCT image showing fracture of the inferior facet of C6. This
was not diagnosed on the plain film. (Continued )

Figure 3. (Cont.) (c) Sagittal multislice CT (MSCT) image confirms an


undisplaced type II dens fracture. (d) Coronal MSCT scan of the dens

Figure 3. (e) A fracture through the anterior part of the C1


ring is demonstrated on the axial MSCT image. This was not
demonstrated on any of the plain radiographs.

Figure 4. (a) Plain lateral radiograph of the cervical spine showing marked
prominence of the pre-vertebral soft tissues following trauma. Pre-vertebral
haemorrghage is suspected. There are degenerative changes at C5/6 with
narrowing of the disc space and sclerosis at the endplates. (b) Sagittal
multislice CT showing osteophytes at C6/7 and disc space narrowing

Figure 5. (a) Plain radiograph (anteroposterior film) showing reduced height


of L3 following fracture and widening of the right L2/3 facet joint space. (b)
Plain radiograph (lateral) demonstrating fracture of L3. There is collapse of

Figure 5. (c) Sagittal multislice CT (MSCT) showing burst fracture of L3 with


multiple fragments anteriorly and posteriorly and a fracture of the lamina of
L3 not identified on the plain film. (d) Coronal MSCT demonstrates burst
fracture of L3 but also fracture of the inferior right corner of L2. The L2

Figure 5. (Cont.) (e) Coronal MSCT showing disrupted right L2/3 facet joint and fracture of the
left lamina of L3 as a result of fracture/rotation of L2 on L3. (f) Three-dimensional MSCT clearly

Figure 5. (g) Sagittal T2 weighted MRI showing compression of the cauda


equina nerve roots by the retropulsed posterior superior fracture fragment of
L3. (h) Sagittal T1 weighted MR image showing severe narrowing of the spinal

Figure 6. (a) Normal sagittal thick slice multiplanar reconstruction (MPR) of


the thoracolumbar spine mimicking lateral plain radiograph. (b) Coronal thick

Figure 7. (a) Oblique plain radiograph showing posterior column fracture of


the acetabulum with a large separated fragment. (b) Sagittal multislice CT
(MSCT) reconstruction of the acetabulum showing the separated posterior

Figure 7. (Cont.) (d) Radiolucent three-dimensional (3D) image


of the pelvis in the sagittal plane showing fracture of the
posterior column with a large separated fragment. (e) 3D

Figure 8. (a) Judet view transluscent three-dimensional (3D) image of the


pelvis demonstrating bilateral sacral fractures, fractures of the right
acetabulum posterior wall and fracture of the left pubic rami. (b) 3D image of

Figure 9. (a) Coronal multiplanar reconstruction (MPR) demonstrating


comminuted fracture of the calcaneum and the main fracture fragments
(sustentaculum, body and lateral fragment. (b) Axial MPR of comminuted

Figure 9. (c) Sagittal MPR of comminuted calcaneal

Figure 10. (a) Plain radiograph showing Lisfranc fracture. There is


malalignment between the second metatarsal and the middle cuneiform
indicating a dislocation at the tarsometatarsal joint. the second
tarsometatarsal joint is identified. There is associated

Terima Kasih. .
.

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