Radiology review: test your radiologic acumen against both routine presentations and extraordinary circumstances from actual case presentations

Radiology review: test your radiologic acumen against both routine presentations and extraordinary circumstances from actual case presentations

Nandan R. Hichkad

You are asked to evaluate a 7-year-old girl brought to the emergency department after she was involved in a motor vehicle crash. The patient was a restrained backseat passenger in a vehicle that was rear-ended by another vehicle. Her primary complaint is back pain.

She had no loss of consciousness and her medical history is unremarkable. Vital signs and initial survey are normal. She does have some localizing tenderness in the lumbosacral region but is able to move all of her extremities well. Strength, sensation, and reflexes are all intact. A lumbosacral radiograph is shown.

Answer

The radiograph shows a Chance fracture L2. Also known as the “seat belt fracture,” such injuries are common and involve both the middle and posterior columns Most are typically managed nonsurgically with bracing and close follow-up.

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Nandan R. Hichkad works in general surgery and emergency medicine in Macon, Georgia.

COPYRIGHT 2005 Clinicians Publishing Group

COPYRIGHT 2005 Gale Group