Discover and read the best of Twitter Threads about #Orthopedics

Most recents (24)

A snapshot in time confounded by @TheNRMP match “algorithm”. The truth is #medicine is we have work to do in #genderequity - US physician workforce only 37% women. Rads 27%, Gen Surg 22%, #EM 👋🏼29%…@acepnow @WomenSurgeons @AmCollSurgeons @radiologyacr @EmergencyDocs…
@AAMCtoday stats on 2021 US physicians by % female. #pediatrics 65%, #orthopedics 5.9%. Note surgical sub speciality ($$$) higher male dominance, medical/primary care higher female…#orthotwitter @aap_peds @aaos1
New generation of US #doctors show progress, by @aamc study on residents and fellows, 47% total female, #gensurg 46%, #radiology still only 27%, #emed 39%…
Based on the @StanfordMed graphic, we can assume why progress for gensurg but why not for Rads…
Read 9 tweets
A 4-YO♂️ treated for tuberculosis for 3 years with chronic cough, kyphosis, recurrent pneumonia, rib osteomyelitis: lung consolidation, mediastinal lymphadenopathy, cervical kyphosis; R-sided paravertebral soft tissue swelling (T3 to T6)

#IDtwitter #radiology #Orthopedics
Serology: ➕for Aspergillus flavus & Aspergillus fumigatus.
Aspiration of the paravertebral soft tissue:
🔬granulomatous inflammation
🧫Acinetobacter spp.


#microbiology #MedTwitter
Nitroblue tetrazolium dye reduction test: no reduction of the nitroblue tetrazolium
No right shift noted in the activated neutrophils in flow cytometry-based DHR assay (E, patient; F, control)


DOI: 10.1097/INF.0000000000001221
Read 6 tweets
How can one reduce the risk of knee #osteoarthritis?

1. Knee osteoarthritis (OA) causes knee pain. It limits mobility, hampers physical activity and contributes to sedentary lifestyle, which in turn, increases the risk of obesity, diabetes, hypertension, heart attack and stroke.
2. Who are at risk of developing knee OA?
*Non-modifiable risk factors:
Female gender and older age
*#obesity: Increases the risk of knee OA three-times. It also accelerates the progression of disease.
#MedTwitter #orthotwitter #orthopedics
3. Knee injury: Traumatic joint injury is a major risk factor for osteoarthritis, particularly at the #knee (i.e. meniscal damage, anterior cruciate ligament rupture, or direct articular cartilage injury). Ref:…
Read 12 tweets
A 59-YO DM, steroid, myasthenia gravis with thymoma: headache & deviation of tongue to the R side with fasciculation suggestive of right 12th cranial nerve palsy

CT: sphenoid sclerotic changes, soft tissue density lesion with calcification.

#neurology #radiology #IDtwitter Image
MRI brain: a hypointense lesion involving the body of sphenoid (R > L) and clivus on T2 weighted images and T1 weighted images with moderate contrast enhancement possibly fungal in aetiology.
#radiologist #radres #MedTwitter ImageImage
Endoscopic sphenoidotomy & debridement: invasive fungal sphenoid sinusitis & CENTRAL SKULL BASE OSTEOMYELITIS involving the clivus

🔬from sphenoid mucosa: morphologically ASPERGILLUS with foci of tissue invasion.

#microbiology #maxillofacial #Orthopedics
Read 8 tweets
Sequence of Kapandji intrafocal pinning for a case of distal radius fracture with intra-articular extension.

#orthotwitter #Orthopedics #handsurgery #congenitalhand
The first wire is passed from the dorsum for correcting the dorsal tilt of the ulnar volar fragment.
The second wires is used to hold and correct the radial tilt of the styloid fragment. It is applied from the radial direction.
Read 4 tweets
Our technique of managing Camapanacci grade 3 giant cell tumor of distal radius. Whole of the distal radius is excised, the ulna is transferred to the gap and a radioscapholunate fusion is done. This retains some amount of motion in the wrist. #orthotwitter ImageImage
This is an illustration of the same. The ulnar artery connections are maintained while transposing the ulna. #Orthopedics #handsurgery #congenitalhand ImageImageImage
This is a representative radiograph if the same. #giantcelltumor ImageImage
Read 5 tweets
1/When it comes to brachial plexus pathology, you shouldn’t have to wing it! A #tweetorial to help you figure out #brachialplexus injuries
#medtwitter #meded #neurosurgery #orthotwitter #orthopedics #neurorad #radres #medstudent #FOAMed #FOAMrad #spine #radiology #neurotwitter Image
2/When it comes to brachial plexus injuries, the most important distinction to make is whether it is a pre or post ganglionic injury. Pre ganglionic injuries are nerve root avulsions from the spinal cord and cannot be repaired, while most post ganglionic injuries can be repaired Image
3/It’s like repairing a house. If there’s a structural flaw at the beginning, before you’ve even built it, you won’t even try to build it, you’ll just scrap the design (preganglionic). But if there’s damage after the house is built, you can salvage it w/repair (postganglionic) Image
Read 16 tweets
1/Ready for some heavy lifting? My second #tweetorial on the BRACHIAL PLEXUS! This time we cover how the #brachialplexus looks on #MRI.

#medtwitter #meded #neurosurgery #orthotwitter #orthopedics #neurorad #radres #medstudent #FOAMed #FOAMrad #spine #radiology #neurotwitter Image
2/Brachial plexus is how the cervical nerves reach the arm. In the coronal plane, it looks like a slide, guiding nerves downward. Bc nerves are traveling laterally, sagittal MRI plane is our plane of choice to cut the nerves in cross section & see down the barrel of the nerves Image
3/But it’s more than a slide, it’s a complex highway, w/nerves joining & dividing—like highway off ramps & on ramps. If you want to know more about this intrinsic anatomy, see my first brachial plexus tweetorial here: Image
Read 18 tweets
1/Raise your hand if you’re confused by the BRACHIAL PLEXUS! I could never quite remember or understand it—but now I do & I’ll show you how
A #tweetorial on #brachialplexus #anatomy!
#medtwitter #meded #neurosurgery #orthotwitter #orthopedics #neurorad #radres #medstudent #FOAMed Image
2/Everyone has a mnemonic to remember brachial plexus anatomy. I’m a radiologist, so I remember one about Rad Techs. But just remembering the names & their order isn’t enough. That is just the starting point--let’s really understand it Image
3/From the mnemonic, we start with the roots—the cervical nerve roots. I remember which roots make up the brachial plexus by remembering that it supplies the hand. You have 5 fingers on your hand so we start with C5 & we take 5 nerve roots (C5-T1). Image
Read 21 tweets
1/Need help reading spine imaging? I’ve got your back!
A #tweetorial about the ABCs of reading spine MRs & CTs.
#medtwitter #FOAMed #FOAMrad #medstudenttwitter #medstudent #neurorad #radres #neurosurgery #spine #orthopedics @medtweetorials @stefantigges Image
2/A is for alignment. Normal spinal alignment is perfectly in balance, resulting in the minimal energy needed for erect posture. Even subtle changes in alignment need compensatory changes to maintain posture, resulting in more work/energy expenditure & pain. Image
3/The goals for alignment on imaging: (1) look for unstable injuries & (2) look for malalignment that causes early degenerative change. Abnormal motion causes spinal elements to abnormally move against each other, like grinding teeth wears down teeth—this wears down the spine Image
Read 19 tweets
18-YO👨‍🦱: painful tender, fluctuant mass mass over the R anterior sin, chronic right knee pain, weight loss.

⬆️inflammatory markers (ESR, CRP)

XR & MR: ?
#Orthopedics #radiology #MedEd
X-ray: areas of lucency & sclerosis in the proximal tibial metadiaphysis
MR: consistent with an chronic osteomyelitis & intraosseous abscess with myositis involving the adjacent musculature

A presumptive diagnosis of BRODIE ABSCESS

#IDtwitter #MedTwitter
Debridement with sequestrectomy
3 deep bone: Aggregatibacter aphrophilus
🔬: bone remodeling, fibrosis, & mixed lymphoplasmacytic & histiocytic infiltrates

#microbiology #Doctor
Read 9 tweets
An in-depth review of Tibial Pilon Fractures.

If you’re interested in orthopedics, you’ll definitely want to check this review out.


To view our past reviews, visit:
💻📱 Image
Most tibial pilon fractures result from high-energy axial loading through the talus.

They are also commonly referred to as Tibial Plafond fractures. The tibial plafond is the distal articular surface of the tibia, which gained the name from its French meaning, "ceiling". Image
The term tibial pilon was first used by Étienne Destot in 1911 to describe the interaction of the distal tibia and talus during axial loading.

Pilon is the French term for "pestle".

The term was later adopted as a term for vertical impaction fractures of the distal tibia. Image
Read 14 tweets
A review of upper extremity Eponym Fractures.

It is important for clinicians to be aware of eponymous fractures as they are commonly used and allow for a succinct description of sometimes complex injuries.


To view our past reviews, visit:
First off, what is an eponym fracture?

Eponymous: of, relating to, or being the person or thing for whom or which something is named.

Eponym fractures are named based on the first person to describe them (e.g. Holstein-Lewis) or by an activity (e.g. Chauffer's)
We will review the eponymous fractures of the upper extremity going from proximal to distal.

To start off, what is an eponym for the following lesion?
Read 24 tweets
An in-depth review of Humeral Shaft Fractures.

If you’re interested in orthopedics, you’ll definitely want to check this review out!


To view our past reviews, check out:
💻📱 Image
The humeral shaft is defined as the area distal to the surgical neck and proximal to the epicondyles.

The commonality of fracture is:
Middle ⅓ > Proximal ⅓ > Distal ⅓ shaft

The deforming forces of humeral shaft fractures usually result in what type of deformity?
Due to the muscular pull of the deltoid on the proximal fragment and medial/superior pull on the distal fragment, humeral shaft fractures tend to develop varus angulation.

Humeral shaft fractures are forgiving, and modest angulation can be overcome by the shoulders' large ROM. Image
Read 16 tweets
An in-depth review of ACL injury.

If you're interested in sports medicine, you won't want to miss this one!


To view our past reviews, check out:
The ACL is the primary restraint to anterior tibial translation and also plays a role in rotary stability

It is composed of two bundles, named based on their tibial insertions:
✯ Anteromedial
✯ Posterolateral

What structure separates the femoral insertions of the two bundles?
AM bundle:
✯ Tightest in Flexion
✯ Resists anterior tibial translation
✯ Tested by Lachman's/Anterior Drawer

PL bundle:
✯ Tightest in Extension
✯ Rotatory Restraint
✯ Tested by Pivot Shift

The bifurcate ridge separates the femoral insertions of the AM and PL bundles.
Read 17 tweets
An in-depth review of Proximal Humerus Fractures.

If you're interested in orthopedics you won't want to miss this one!


To view our past reviews visit:
Proximal humerus fractures are common, accounting for around 5% of all fractures with increasing frequency with age.

They are most common in elderly females and are considered a fragility fracture.

Which nerve is most commonly injured in proximal humerus fractures?
The axillary nerve passes medial to the surgical neck and is most commonly injured in proximal humerus fractures.

Sensation testing over the lateral shoulder may be performed as deltoid testing may be difficult.

Which artery provides the main blood supply to the humeral head?
Read 16 tweets
An in-depth review of Clavicle Fractures.

If you're interested in orthopedics you won't want to miss this one!

Clavicle fractures are typically the result of a fall onto the shoulder and are one of the most common fractures in children.

They may also occur from direct trauma, seizures, or a fall onto an outstretched hand (FOOSH).
The clavicle serves as the connection between the UE and axial skeleton.

It is the first bone to ossify and the last to fuse. It is S-shaped and widest medially.

Most fractures occur in the middle 1/3rd, roughly 80%, which is the thinnest segment.
Read 17 tweets
An in-depth review of intertrochanteric and subtrochanteric hip fractures.

If you're interested in orthopedics you won't want to miss this one!

Basicervical femoral neck, intertrochanteric (IT), and subtrochanteric (ST) hip fractures are different from femoral neck fractures in that they are extracapsular.

Extracapsular fractures, unlike intracapsular femoral neck fx, have a low likelihood of blood supply disruption/AVN
The calcar femorale is an extension of cortical bone from the proximal shaft to the posteromedial femoral neck. It aids in weight distribution from the hip to the proximal femoral shaft.

The subtrochanteric region extends 5 cm below the lesser trochanter.
Read 14 tweets
An in-depth review of Ankle Fractures.

If you're interested in orthopedics you'll definitely want to check this review out!

The ankle is a complex hinge joint comprised of the tibial plafond, talar dome, and distal fibula.

Ankle fractures most commonly occur in elderly females, with roughly 70% being isolated malleolar, 20% being bimalleolar, and 5-10% being trimalleolar. (1)
When first examining a patient with an ankle injury, you can utilize the Ottawa Ankle Rules to determine if you should x-ray the patient.

Our review of The Ottawa Ankle Rules can be found here:
Read 20 tweets
An in-depth review of Terrible Triad Injuries.

If you're interested in orthopedics you won't want to miss this one!

Terrible triad injuries are complex posterior elbow dislocations associated with coronoid and radial head fractures as well as capsular and ligamentous injuries.
These injuries commonly result from a fall on an outstretched arm and the structures of the elbow fail from lateral to medial.

LCL --> anterior capsule --> MCL
Read 13 tweets
An in-depth review of pediatric femoral shaft fractures.

If you're interested in orthopedics or pediatrics you'll definitely want to check this review out!

Pediatric femoral shaft (PFS) fractures constitute a small portion of pediatric fractures roughly 1-2% with a bimodal age distribution

Most common causes:
✯ Toddlers: falls
✯ Teenage/adolescent: MVA
In children younger than walking age child abuse must be suspected. As high as 80% of PFS fractures in this age group are due to child abuse.

In the toddler age group as high as 25% of PFS fractures are due to child abuse, so it must be ruled out.
Read 11 tweets
An in-depth review of metacarpal fractures.

If you're interested in orthopedics you'll definitely want to check this review out!

What is an eponym for this fracture? Image
This patient is presenting with an intraarticular fx of the 5th metacarpal base.

This fracture is similar to a Bennett's fx (an intraarticular fx of the 1st metacarpal base).

This fracture goes by a few eponyms: a reverse bennett, baby bennett, or mirrored bennett. Image
A Ronaldo fracture is a comminuted fracture of the 1st metacarpal base. (shown above)

Displacement of a Reverse Bennett fracture is due to which of the following muscles?
Read 14 tweets
An in-depth review of Slipped Capital Femoral Epiphysis (SCFE).

If you're interested in orthopedics or pediatrics you'll definitely want to check this review out!

1/ Image
SCFE’s are an adolescent hip pathology with an average age of onset of 11-12.

The diagnosis may be initially missed because the patient may present with thigh or knee pain.
Risk factors include:
✯ Obesity
✯ Male gender
✯ Prior radiation
✯ Endocrine abnormalities
✯ Certain ethnicities (e.g. African American)

Obesity is one of the most important and modifiable risk factors.
Read 12 tweets
An in-depth review of Distal Humerus Fractures.

If you're interested in orthopedics you'll definitely want to check this review out.

1/12 Image
The distal humerus is composed of two columns, a medial and lateral column that are connected by the trochlea forming a triangular shape.

The distal humerus has:
40-45° anterior angulation
3-8° internal rotation
4-8° valgus Image
Distal humerus fractures most commonly occur in elderly females due to low energy falls, but may also occur in young adults due to MVA or sporting events.
Read 13 tweets

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