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Normal Abdominal amp Pelvic CT Anatomy Algorithm – Radiology Lecturio
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http://youtube.com/watch?v=NihfklGzubM
Dr. Ebraheim’s educational animated video describes fractures of the acetabulum - T-Shaped fracture. • Follow me on twitter: • https://twitter.com/#!/DrEbraheim_UTMC • T-shape facture of the acetabular is like a transverse fracture in addition to a vertical component fracture that is going towards the obturator foramen and is best seen on the obturator oblique view. If you see extension of the fracture through the medial wall of the acetabulum and the fracture is going through the obturator ring, then this is a T-shaped fracture. In general, you will have a superior iliac segment which is superior to the transverse fracture. There will also be an inferior ischiopubic segment which is split, usually by a vertical stem of a “T”. There will be two separate segments: the anterior articular segment (pubic) and the posterior articular segment (ischial). Usually the femoral head will displace medially and two caudal segments will rotate around the femoral head. Two approaches may be needed to fix this fracture. Because part of the articular surface remains attached to the iliac wing, then this fracture is not an associated BOTH column fracture. X-ray will show that the iliopectineal line and the ilioischial line are interrupted in addition to involvement of the obturator foramen or the presence of an ischial ramus fracture. By definition, this is a T-type fracture of the acetabulum. The inferior stem of the T-shaped fracture can be going in different directions. The fracture can be directed posteriorly, vertically, or anteriorly. CT scan will show the vertical line fracture, which is sometimes called the sagittal fracture. This represents the transverse part of the T-shaped fracture. Where do you see the vertical stem of the T-shaped fracture? If you see extension of a transverse fracture of the acetabulum through the medial wall of the acetabulum and the fracture is going through the obturator ring, then this is a T-shaped fracture. The vertical component of the fracture is best seen in an obturator oblique view. There are different patterns of different acetabular fractures which can be confusing. The first one is the transverse fracture of the acetabular and one can see the vertical or sagittal line. The second one is the T-shaped fracture. In the T-shaped fracture, one can see the sagittal fracture of the acetabulum with vertical fracture of the inner wall of the acetabulum. The third example is the posterior column and posterior wall fracture. It involves the inner wall but lacks the sagittal component of the transverse acetabular fracture pattern.
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