Pelvic Ring Injury, CT, anterior-posterior compression
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This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0538-Pelvic Ring Injury, CT, anterior-posterior compression
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CA0538-Pelvic Ring Injury, CT, anterior-posterior compression
Case ReportHistory
Exam
Findings
Findings
There is a comminuted fracture of the sacrum with involvement of the S3, S4, and S5 segments. Fracture lines extend to the S3 and S4 foramina bilaterally and involve the sacral canal (Denis zone 3). There is a dominant transverse fracture at the S4 level with 0.4 cm anterior displacement of S4 with respect to S3.
Widening of the anterior right sacroiliac joint. Left sacroiliac joint alignment is within normal limits.
Widening of the pubic symphysis to 2.0 cm with pelvic binder in place.
Right L4 transverse process fracture.
Multiple vascular blushes are identified about the pelvis, including in the right ischiorectal fossa, adjacent to the widened pubic symphysis, adjacent to the left ischial tuberosity, and in the bilateral gluteal muscles.
Multiple areas of edema/hemorrhage throughout the superficial adipose layer of the pelvis.
Edema/hemorrhage in multiple locations of the retroperitoneum, particularly adjacent to the bladder, which is decompressed about a Foley catheter.
Degenerative disc disease and facet osteoarthritis. Posterior lumbar fusion hardware noted. L4 laminectomy. Mild bilateral sacroiliac joint degenerative change. Bilateral hip osteoarthritis.
Impression
Right L4 transverse process fracture.
Multiple areas of associated soft tissue injury, some with vascular blushes suggesting active hemorrhage.
Hemorrhage/edema about the bladder.
Recommendations
Orthopedic surgery consultation.
