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reading an x-ray
check patients naem to make sure its the right x-ray
check the date of film was taken (if patient has multiple put them in date order)
put film on x-ray box right way around
look at markers on film for left and right
ABC’s of reading an x-ray
alignment : relationship of bones to each other
bones: does it appear normal, any deviations, does it look dense
cartiliage: discs in spine
soft tissue: may be able to see shadow of muscles, fat in joint
too little density - underexposure (appears white)
too much density - overexposure (appears too dark)
arthroplasty
surgical joint replacement
primary purpose to improve quality of life
who is a good candidate
severe pain and stiffness affecting adls
failed conservative management
impacted mobility and function
when surgery is not the right option
mild symptoms
psychological distress
high BMI (>40)
young age (<60 years)
surgical options for hip
total hip replacement - a procedure to replace the hip joint with a prosthesis. for OA, slightly higher in female
hemiarthroplasty - replacement of femoral head only - associated with #NOF
hip resurfacing - replacement of articular surface - osteonecrosis and OA - younger population 53yrs
revision THR - removal and replacement of hip prosthesis
three main approaches to hip surgery
posterolateral approach - common, muscle cutting, more precautions
anterior approach - muscle sparing, fewer restrictions
direct lateral approach - may affect abductors, caution with GT repair
surgical options for knee
total knee replacment - a procedure to replace the knee joint with a prosthesis, often for arthritisv- OA - 68yrs - females higher
unicompartmental knee repacment - OA - males more
revision TKR
knee surgical approaches
most common is medial parapatellar approach because avoids quad muscles
shoulder surgical approach
deltopectoral approach - common -
superior - common for reverse total shoulder
anterior approach
post op restrictions
for lower limb usually WBAT unless complications then go to PWB
for revision surgeries usually go on the side of caution and PWB
shoulder - COTWB or NWB, cup of tea wb