Accessory Ossicle |
Apophysis |
Normal Epiphyseal Plate |
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Multiple ossification centers are
common in epiphyses and are
smooth and well-corticated |
Apophysis of the 5th MT runs in a
longitudinal direction; fractures are
usually transverse |
Don't confuse the undulations
of the humeral epiphyseal plate
for a
fracture |
Bipartite Patella |
Nutrient Channel (Canal) |
Normal Excrescence |
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Bipartite patella almost always
affects the upper outer pole of
patella; 57% are bilateral |
Nutrient channels or canals run
diagonally only in the cortices of
certain
bones |
Radial spur is normal variant
occurring on the lateral aspect of the
radius at the site of the physis |
Normal Apophysis |
Limbus Vertebra |
Normal Excresence |
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The apophysis of the tibial tubercle
(tuberosity) fuses at age 14-18 years |
Most commonly affects antero-
superior border of single vertebra
in lumbar spine |
This is a normal bony
excresence from the scaphoid that
can be mistaken for a fracture |
Sesamoids |
Skin Laceration |
Apophysis |
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Sesamoids are ossicles embedded in a tendon that aid in movement; they are common in the feet and hands |
Air beneath lacerations may superimpose
on the bone simulating fractures; look at multiple projections |
The greater and lesser trochanters
are apophyses which fuse at 15-20
years of age |
Lack of Fusion |
Mach Line |
Accessory Epiphyses |
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Hyoid Bone fuse later in life
usually by age 40; it is therefore
common to see and unfused hyoid |
"Mach Lines" are optical illusions which
produce a black line where none exists; they are common at the base of the dens |
In a child, when in doubt, think of obtaining the opposite side for comparison; mouse-over |
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Costovertebral Junction |
Accessory Ossicle |
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3 main temporary joints in pelvis: ilio-pubic, ischio-pubic and ilio-ischial; bilateral and usually symmetric |
Every rib attaches to the spine at the
costo-vertebral junction; not to be
confused with a fracture
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Os Acetabuli Marginalis Superior
Normal variant
May be bilateral
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Multiple Ossification Centers
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Sesamoids |
Accessory Ossicle |
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The calcaneal apophysis frequently has multiple centers of ossification and appears denser than rest of calcaneous
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There are almost always sesamoids of the thumb; they are well-corticated and smooth-edged, unlike fractures |
Os Trigonum-accessory ossicle just posterior to the talus normally found in 5-15% of people
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