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Ossification of Carpal Bones

It’s always tricky to remember the age of ossification of the carpal bones
Ossification of ... remember the age of ossification ... and sequence of ossification ... -6-7 years for Triquetral ... drdevradiology #Ossification
Age of Ossification of Carpal Bones
Capitate - 1 Month
Hamate - 2 Months
Triquetral - 3 Years
Lunate -
Age of Ossification ... of Carpal Bones ... Hamate - 2 Months Triquetral ... of the carpal bones ... #Age #Carpal #Bones
Triquetral Fracture
The triquetrum is the second most commonly fractured carpal bone. Look for the "pooping duck
The triquetrum ... fractured carpal bone ... "pooping duck sign ... common carpal bone ... "pooping duck sign
Feedback Loop: Growth Hormone (GH)
Growth Hormone:
 • Liver -> GHR activates JAK-STAT pathway -> Incr IGF1
Incr IGF1 • Bone ... chondrocytes -> Incr ossification ... activates lipolysis Signs
Most Common Carpal Bone Fractures by Frequency
 • Scaphoid - 50-80%
 • Triquetral - 5-20%
 •
Common Carpal Bone ... Scaphoid - 50-80% • Triquetral ... drdevrad #Carpal #Bone
Basilar Skull Fracture
Fracture through petrous portion of temporal bone 
 - Periorbital ecchymosis 
 - Hemotympanum
portion of temporal bone ... ecchymosis (Battle's sign ... Fracture #Battles #Signs
Symptoms of Hypophosphatemia
 • CNS: Seizures, Delirium, Paresthesias, Central & extrapontine myelinolysis, Hallucinations, Fatigue
 • Hematologic:
Heart failure • Bones ... Growth retardation, Bone ... Phosphate #Symptoms #Signs
Hyperparathyroidism - Primary vs Secondary vs Tertiary 
Lab Comparison:
 • Primary Hyperparathyroidism: ↑→PTH, ↑Calcium, ↑Vitamin D,
Symptoms: Commonly no signs ... , Fragile bones/ ... easily/weakness, Bone
Common Hand Fractures on X-Ray
Mallet finger - injury to the lateral extensor slips
Boutonniere deformity - injury
Terry thomas sign ... Triquetral fracture
Supracondylar Elbow Fracture
• Most common elbow fracture in children, peak age 5-7 
• When looking at
posterior) and bone ... anterior sail sign ... fracture' • Ossification ... can't make A-OK sign