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    Go to the top of the page   ID: 20011125215323 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture
    Wolfgang Hirsch, S-O Höhne. Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture. PedRad [serial online] vol 1, no. 11.
    URL: www.PedRad.info/?search=20011125215323


    ( There are questions in the CMK-Mode for this topic )

     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Wolfgang Hirsch, S.-O. Höhne (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    N/A  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    Leg-Bones  

     
     Pediatric Radiology CasesMost likely etiology:

    physical  

     
     Pediatric Radiology CasesHistory:

    After distorsion trauma and pain at the lateral maleolus and in the distal diaphysial region of the tibia.

    Lateral maleolus fractures are without the help of MRI often misread. According to v. Laer, this is a 5-Kadi-Lesion (in a misdiagnosis or rather a misreading: down before the Kadi!!)  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Frequent in supination trauma: Tendon lesion and extensive clinical symptoms which lie laterally; Fractures (by the hitting of the medial malleolus onto the talus) are found, however, medially (with less symptoms).  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Fracture of the medial malleolus is not seen in the a.p. x-ray.







    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral: Possible Aitken I Fracture in the dorsal area of the metaphysis of the distal tibial metaphysis.







    MRI 1 <- view MRI 1

    MRI 1: (T2 with fat supression - coronal) White, horizontal (fluid-filled) line of fracture through the medial malleolus without dislocation = Aitken II (could not be seen in conventional x-ray). Confirmation of the bright Aitken I fracture of the dorsal tibial metaphysis (diagonal in the coronal image). Only a small amount of edema is seen in the marrow = bone-bruise, trabecular fracture. Slight increase in fluid in the joint (T2-weighted fat-suppressed sequence)









    MRI 2 <- view MRI 2

    MRI 2: (T1 - Sagittal) Dark, strong lines in the dorsal area of the metaphysis (corresponding to the lateral x-ray). The surrounding dark area is comparable to the obvious marrow edema (in T1-SE: dark).




     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    In this extreme and patient history - obvious findings.
    Otherwise also marrow edema of other cause (inflammation, tumor). Patient history?  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    If no step on the joint is seen, no early arthrosis, but danger of a pseudoarthrosis if misdiagnosis.

    In cartilage-stepping or damage: Early arthrosis.

    !!! - This is one of the 5 Kadi-fractures (according to v.Laer)  

     
     Pediatric Radiology CasesComments of the author about the case:

    From our experience, fractures of the medial maleolus are often initally detected in MRI. Generally, fractures of the upper ankle joint, due to the complexity of the joint and the strong bone mass, are not detected conventionally.

    In case there is no MRI availabe: In suspicion of a medial maleolus fracture, a.p.-image (in addition to the normal image with 30° inner rotation).  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Aitken, fracture, ankle joint, Salter, Harris, Salter-Harris, Salter-Harris fracture, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Wolfgang Hirsch, S-O Höhne. Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture. PedRad [serial online] vol 1, no. 11.
    URL: www.PedRad.info/?search=20011125215323  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Leg-Bones
    or in the region: Leg
    or in the tissue/organ: Bones
    or with the etiology: physical
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture
    Wolfgang Hirsch, S-O Höhne. Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture. PedRad [serial online] vol 1, no. 11.
    URL: www.PedRad.info/?search=20011125215323


    ( There are questions in the CMK-Mode for this topic )

     

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    Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture
    Other cases by these authors:

    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search S.-O. Höhne in Medline S.-O. Höhne (2)   

    Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture  
     
    Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture
    Wolfgang Hirsch, S-O Höhne. Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture. PedRad [serial online] vol 1, no. 11.
    URL: www.PedRad.info/?search=20011125215323


    ( There are questions in the CMK-Mode for this topic )

     
     
    Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture
    Wolfgang Hirsch, S-O Höhne. Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture. PedRad [serial online] vol 1, no. 11.
    URL: www.PedRad.info/?search=20011125215323


    ( There are questions in the CMK-Mode for this topic )

     

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    Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture
    Wolfgang Hirsch, S-O Höhne. Fracture of the ankle joint / Aitken I distal tibia metaphysis and malleolus medialis fracture. PedRad [serial online] vol 1, no. 11.
    URL: www.PedRad.info/?search=20011125215323


    ( There are questions in the CMK-Mode for this topic )

     




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