This clinical procedural photograph demonstrates the point-of-care ultrasound (POCUS) technique for diagnosing a 'pulled elbow' (radial head subluxation) in a pediatric patient. The child is positioned supine on a medical examination table with the head turned laterally. A medical professional is seen applying a high-frequency linear ultrasound transducer to the posterior-lateral aspect of the patient's elbow joint. The probe is oriented caudally to visualize the radiohumeral joint and the annular ligament. In the background, an ultrasound monitor displays a real-time grayscale musculoskeletal image. This procedure is used in pediatric emergency medicine to identify signs such as an increased distance between the radial head and the humerus capitate or the interposition of the annular ligament, which confirms subluxation. The image illustrates proper hand placement for stabilizing the young patient's limb while manipulating the transducer to achieve diagnostic views.

This diagnostic image is a lateral X-ray of a human elbow joint following procedural reduction of a radial head dislocation and elbow subluxation. The radiograph demonstrates restored anatomical alignment: the radial head is congruent with the humeral capitellum, and the ulnohumeral articulation appears well-positioned. No obvious cortical fractures or avulsion fragments are visible in the distal humerus, proximal radius, or ulna. A red arrow points to a subtle, localized area of increased radiopacity within the anterior joint space, suggestive of joint effusion or hemarthrosis. This finding is characterized by a density that is higher than the surrounding soft tissue but significantly lower than the adjacent cortical bone. The image serves as an educational example of post-reduction radiological assessment in emergency orthopedics, highlighting successful joint realignment and secondary signs of intra-articular trauma such as hemarthrosis.

Diagnostic imaging series of the right elbow demonstrating an anteromedial fracture-dislocation of the radial head. Panels (a-c) present volume-rendered 3D CT reconstructions in anterior oblique and anteroposterior views, highlighting a comminuted radial head fracture involving approximately 25% of the articular surface. Small osseous fragments are visible wedged posterior to the radial head and within the radial notch of the ulna. Rotatory subluxation is indicated by the malalignment of the ulnar trochlear notch relative to the humeral trochlea. Panels (d-e) show axial CT slices, and (f-g) show sagittal slices in soft tissue windows. These cross-sectional images identify the brachialis tendon (white arrows) as a linear hyperdensity traversing posterolateral to the radial head fracture site. This anatomical relationship is clinically significant as it illustrates a soft tissue 'sling' effect that can impede manual reduction of the dislocation. The content is suitable for orthopedic and radiology education focusing on complex elbow trauma and the identification of mechanical blocks to reduction.

This diagnostic image is a lateral X-ray radiograph of the elbow joint. It demonstrates significant musculoskeletal pathology involving the proximal forearm and distal humerus. The primary finding is a radial head dislocation, where the radial head is displaced anteriorly and is no longer articulating with the capitellum of the humerus. This misalignment is indicated by a red arrow pointing toward the displaced radial head. Additionally, the image shows signs of elbow subluxation, characterized by an incongruous relationship between the trochlear notch of the ulna and the trochlea of the humerus, suggesting partial loss of contact between the joint surfaces. Key anatomical landmarks visible include the distal humeral epicondyles, the olecranon process, and the coronoid process of the ulna. There is no evidence of an acute fracture in this projection. This radiographic study is clinically significant for diagnosing complex elbow injuries and assessing the need for orthopedic reduction. It serves as an educational example of traumatic joint disruption for students and clinicians in emergency medicine and orthopedics.

This composite educational graphic details the intraosseous arterial blood supply of the femoral head through anatomical diagrams and microscopic vascular casts. The main illustration labels the key nutrient vessels: Superior (SRA), Inferior (IRA), and Anterior (ARA) Retinacular Arteries, which transition into Superior (SEA), Inferior (IEA), and Anterior (AEA) Epiphyseal Arteries. The graphic identifies three distinct patterns of arterial anastomosis within the femoral head epiphysis: 1. Superior-inferior Epiphyseal artery anastomosis (57%), 2. Inferior-anterior Epiphyseal artery anastomosis (30%), and 3. Uniform anastomosis (13%). Each variation is represented by a schematic illustrating the dominant arterial loops and a corresponding high-magnification photograph of a microscopic vessel cast, showing the intricate, three-dimensional network of small vessels (≥0.05 mm). This visualization highlights the redundancy of the femoral head's blood supply, which is critical for understanding the pathophysiology of femoral neck fractures and avascular necrosis.

This figure showcases a human tibia specimen prepared using an advanced vascular casting and bone-clearing technique to demonstrate internal intraosseous blood supply. Figures a (rear view), b (side view), and c (front view) display the physical specimen where the cortical bone has been replaced with a transparent epoxy resin. Inside the clear diaphysis, the intraosseous vascular network is clearly visible, highlighted by a red casting agent. The network shows the primary nutrient artery entering the medullary cavity and bifurcating into ascending and descending medullary trunks with subsequent terminal branching toward the proximal and distal metaphyses. The arrangement reveals higher vessel density at the epiphyses compared to the mid-shaft. Figure d provides a complementary 3D digital model of the same tibia, illustrating the external anatomical landmarks and surface morphology used for resin mold construction. This anatomical demonstration is crucial for orthopedic surgical planning, particularly in understanding bone vascularization and nutrient foramen localization.

Plain Radiography of a long bone diaphysis demonstrates an aggressive, ill-defined osteolytic lesion with cortical destruction and periosteal reaction. The radiograph shows a moth-eaten destruction pattern with diffuse bone loss extending along a substantial portion of the shaft. Periosteal elevation produces Codman triangle in the swept cortex, while layered deposition of reactive new bone beneath the periosteum can create an onion-skin appearance; in some cases perpendicular radiating spicules or sunburst-like projections may be seen. The lesion often breaches the cortex or expands to form a soft tissue mass that extends beyond the bone. Although ultrasound or CT can delineate the soft tissue component, CT and MRI best characterize the extent, relation to surrounding structures, and marrow involvement. The radiographic pattern is highly suggestive of an aggressive small round blue cell tumor, most notably Ewing sarcoma, particularly in children and adolescents. Differential considerations include osteosarcoma, osteomyelitis, lymphoma, metastasis, or eosinophilic granuloma, but the combination of an diaphyseal, permeative lesion with onion-skin periosteal reaction strongly favors Ewing. Clinical correlation with pain, fever, raised inflammatory markers, and prompt biopsy is essential to confirm diagnosis and guide treatment, which typically combines chemotherapy, limb-sparing surgery, and possibly radiotherapy.

This composite of three 3D surface-rendered models (A, B, and C) illustrates the spatial relationship between bone macrostructure and microvasculature, likely in a mammalian femur model. Panel A shows an undecalcified bone model displaying the cortical shaft, marrow cavity, and trabecular network in the metaphysis. A central medullary artery (arrow) is visible running longitudinally. Panel B depicts the vascular cast alone after decalcification, highlighting the nutrient artery, its primary branches, and a dense network of sinusoid capillaries within the metaphysis. External arrows point to the periosteal arteries and branched peripheral networks. Panel C demonstrates the over-imposition of both models, utilizing pseudo-coloring to differentiate the calcified bone matrix (lighter gray) from the internal and external vascular systems (darker gray). The imaging modality is micro-computed tomography (µCT) with vascular contrast agents, designed to study bone-vessel interactions, such as those occurring in normal physiology or pathological states like metastasis or osteolysis. The visualization highlights anatomical regions including the diaphysis, metaphysis, and epiphysis.

This clinical photograph captures an intraoperative view of an open reduction and internal fixation (ORIF) of a humeral fracture. The surgical site is prepared with blue sterile drapes and accessed via an anterolateral Henry’s approach. Several metallic surgical retractors (including Hohmann-style and right-angle retractors) are positioned to maintain visualization of the surgical field by retracting the biceps and brachialis muscles. A stainless steel orthopedic locking compression plate (LCP) or limited contact dynamic compression plate (LC-DCP) is shown positioned over the anterolateral surface of the humerus. Several screw holes are visible in the plate, with some already occupied by cortical or locking screws to stabilize the bone fragments. The image demonstrates the critical steps of alignment and hardware placement in orthopedic trauma surgery. Visible landmarks include the flexed elbow with skin markings and the deep exposure of the humeral shaft, emphasizing the relationship between the implant and the underlying musculoskeletal anatomy.

A clinical photograph of an orthopedic surgical implant: a Locking Compression Plate (LCP) designed for the superior anterior clavicle, manufactured using Electron Beam Melting (EBM) 3D printing technology from Ti-6Al-4V titanium alloy. The plate exhibits a contoured, elongated, and slightly curved morphology to match the anatomical shape of the clavicle. The proximal end (left) features a widened head with multiple small, circular locking screw holes. The distal shaft (right) contains three larger, oval-shaped dynamic compression apertures. The surface texture is notably granular and matte, characteristic of the additive manufacturing process, with visible rough edges and surface irregularities likely due to partially melted powder particles. This specimen demonstrates the application of patient-specific additive manufacturing in orthopedic trauma surgery to enhance implant strength and fit compared to traditional forged or cast plates.

A series of clinical photographs and hardware images demonstrating orthopedic internal fixation. Panels (A) and (B) show the structural design of two 9-hole orthopedic plates: a Locking Compression Plate (LCP) with combination holes allowing for both locking and compression screws, and a Limited Contact Dynamic Compression Plate (LC-DCP) with uniform oblong holes designed to reduce bone-to-plate contact and protect periosteal blood supply. Panels (C) through (F) depict the surgical application of these plates on a femur using the Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) technique. The images show small skin incisions, the insertion of the plates along the bone shaft using surgical forceps, and the subsequent fixation with screws through these limited portals. This visual material illustrates the comparative surgical approach and hardware characteristics used in veterinary orthopedic surgery, specifically focusing on femoral fracture management and the biological advantages of minimally invasive plate osteosynthesis over traditional open reduction.

This comparison photograph illustrates the pre-operative planning and contouring of an orthopedic osteosynthesis plate using a patient-specific 3D-printed anatomical model. The images show a side-by-side 'before' and 'after' view of a metallic 3.5-mm locking compression plate (LCP) being adapted for acromial fixation. The plate features a series of Combi holes, designed for both angle-stable locking screws and dynamic compression cortical screws. In the left frame, the distal clavicle reconstruction plate is positioned relatively flat against the white 3D-printed model of the acromion. In the right frame, following manual contouring with plate benders, the plate exhibits a distinct anterior curvature. This adjustment is designed to lift the anterior acromion, correcting for down-sloping to prevent subacromial impingement on the rotator cuff. The use of 3D printing in this context demonstrates advanced surgical planning for complex orthopedic anatomy where standard pre-contoured plates are unavailable.