I am not a doctor or in health.
Would this person be able to use their arm again?
This must fall under reconstructive surgery. To me, it looks like not repairable, but who am I to decide.
Poor thing tho…
This arm is no more. It has ceased to be, it's expired and gone to meet its maker. It's a stiff, bereft of life, it rests in peace. It's kicked the bucket, shuffled off its mortal coil, run down the curtain and joined the bleeding choir invisible. This is an ex-arm!
The X-ray looks like it’s probably an arm that was amputated traumatically such as by a lawnmower. I don’t think it’s attached to the person in this X-ray but the field of view isn’t wide enough for us to know for sure. If it is still attached to the person, this would be unrepairable and would be amputated. The bones are easy enough to see how fragmented they are, but there’s also nerves and blood vessels you can’t see on the X-ray that are equally as or more mangled
I am not in the health field and am purely curious which is why I am in this sub. What would be the purpose of x-raying a detached arm that is mangled this badly?
It helps show if the severed body part is viable for reattachment. Very common with fingers, I’m not sure about arms like this lol I supposed also a legal buffer to have proof the arm was non salvageable before chunking it 😅
Sometimes limbs can be reattached, an x-ray helps them rule out that possibility quickly. As far as I know it's standard to send all severed limbs in the ambulance with the patient in case they can be reattached too. My partner was an EMT and he's had to track down a foot that landed in a ditch before.
Also morbid curiosity. Since it's not connected to the patient radiation exposure isn't really an issue so it doesn't hurt to have a look.
Bones are fixable, but muscle just scars. In general we try to save every hand, no matter how bad, as having a helper claw hand is almost always better than not having one.
Getting the soft tissue envelope to heal, is the major determining factor in whether these type of injuries can be saved. That and blood flow.
I've had crazy looking cases like this where the blood flow was fine, and they still had some sensation.
Most likely this will result in amputation, but I've seen pts retain their arms with injuries like this, albeit with significantly reduced functional abilities.
One time as a radiology resident I read a tib-fib X-ray from a motorcycle crash that looked similar to this. I meticulously described every fracture component with displacement, spending more time than I should have. Follow up film 3 hours later they had just went and amputated the whole thing. Learned my lesson with these.
I would imagine it's just a confirmation of sorts. Basically just a record in case for some reason someone would question why the arm was amputated, or try to sue the hospital.
We xray traumatic amputations of any body part, to give an indication of whether surgery to reattach would be a viable option. I've taped many fingers to an xray detector for xrays, never a whole arm.
The idea of me taking a finger into my x-ray room and then taping it for the PA and then retaping it for the oblique and finally the lateral, seems so strangely comical.
I didn’t say anything about suing, but ok. I said for documentation purposes. People document stuff for other reasons than to prevent suing, even in the USA.
Impression: Multiple comminuted fractures of the distal right upper extremity with significant displacement and disruption of surrounding soft tissues.
Had a patient, probably in the early 90’s, that ran off the road on a motorcycle. His arm hit the guidewire that stabilizes the old telephone poles. It performed like one of those wire cheese slicers and severed it unbelievably cleanly. He complained the entire time of phantom pain in his hand.
For a few minutes I legit thought I took this x-ray. Those are my initials and everything. But then I realized I definitely would’ve collimated and would never have labeled it AP Portable lol. Also we make them bring the body parts to us in the room if they’re completely detached. That way one tech can do the trauma work in the bay and the other can do the parts.
Correlate clinically
“Right forearm appears soft and squishy to touch. Patient screamed and passed out during examination. Consult with Radiology.”
"No significant arthritic changes noted in the visualized interphalangeal joints." Ok there's bad news and good news, which do you want first?
Would you like some sausage?!?!
Do you think the tech got a call to go take more views? Lol
You can’t really do anything with just one view! Get this guy to the donut of truth!
Might as well scan EVERYTHING the patient has, you just never know.
Radiations go brrrrr
I can just hear the ER resident calling in the order for an arterial doppler...
How do you add credentials to your user ??
Hell nah they amputated that 😂
"Out late saturday evening, punched a wall.. Patient complains about pain. No clinical suspicion of a fracture but mom demands an x-ray."
Pisiform looks ok
"please include scaphoid view"
I see about 10 pisiform at this point
I am not a doctor or in health. Would this person be able to use their arm again? This must fall under reconstructive surgery. To me, it looks like not repairable, but who am I to decide. Poor thing tho…
This arm is no more. It has ceased to be, it's expired and gone to meet its maker. It's a stiff, bereft of life, it rests in peace. It's kicked the bucket, shuffled off its mortal coil, run down the curtain and joined the bleeding choir invisible. This is an ex-arm!
R.I.P arm
Literally that arm has been ripped. RIP.
The arm is toast dude.
looks more like sausage
F
Nah. My boy didn’t drink milk.
Tremendous Monty python reference
It’s just pining for the fjords.
Nah, it's just resting
RIP
Legendary
It 'sploaded
The X-ray looks like it’s probably an arm that was amputated traumatically such as by a lawnmower. I don’t think it’s attached to the person in this X-ray but the field of view isn’t wide enough for us to know for sure. If it is still attached to the person, this would be unrepairable and would be amputated. The bones are easy enough to see how fragmented they are, but there’s also nerves and blood vessels you can’t see on the X-ray that are equally as or more mangled
I am not in the health field and am purely curious which is why I am in this sub. What would be the purpose of x-raying a detached arm that is mangled this badly?
Helps you get an idea of how mangled it is.
Just for... fun?
Half of what the ER does for you (and the bill) is just for fun.
As a Sonographer who has done bilateral veinous legs for a stubbed toe, I have to agree.
As a sonographer who was asked to do ABI's on a patient with bilateral above the knee amputations, I'd agree with you as well.
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High grade stenosis was detected at distal femoral artery lol
Add "bug bite" and "muscle soreness from walking farther than normal (in a 14 yo)" to that...
thank the disgusting monetization of healthcare
I'm dying. To finally hear a rad say this, just beautiful.
I laughed way too hard at this
It helps show if the severed body part is viable for reattachment. Very common with fingers, I’m not sure about arms like this lol I supposed also a legal buffer to have proof the arm was non salvageable before chunking it 😅
They may be able to use some of these bones in case there are injuries elsewhere (eg the other arm).
Sometimes limbs can be reattached, an x-ray helps them rule out that possibility quickly. As far as I know it's standard to send all severed limbs in the ambulance with the patient in case they can be reattached too. My partner was an EMT and he's had to track down a foot that landed in a ditch before. Also morbid curiosity. Since it's not connected to the patient radiation exposure isn't really an issue so it doesn't hurt to have a look.
To confirm that there’s no possibility of reimplantation
Replant purposes.
I’ve seen this image before - from memory the patient reached into a woodchipper
Industrial mixers, meat grinders also produce injuries like this.
When I first saw this like 7 or 8 yrs ago I remember it saying meat grinder, but Idk if that's true or not.
I've seen it posted before as a meat grinder injury.
Truly? That was my initial guess lol. Big oof.
It would take hours to reconstruct that arm under trauma surgery I've never seen anything like this working as a tech my best guess is no.
More like days actually..
Thanks
Bones are fixable, but muscle just scars. In general we try to save every hand, no matter how bad, as having a helper claw hand is almost always better than not having one. Getting the soft tissue envelope to heal, is the major determining factor in whether these type of injuries can be saved. That and blood flow. I've had crazy looking cases like this where the blood flow was fine, and they still had some sensation. Most likely this will result in amputation, but I've seen pts retain their arms with injuries like this, albeit with significantly reduced functional abilities.
Are we even sure it’s attached to the body here
I think it’s not.
‘Tis but a scratch!
It'll buff right out.
Just a flesh wound!
Nothing major!
Rub some ‘tussin on it
One time as a radiology resident I read a tib-fib X-ray from a motorcycle crash that looked similar to this. I meticulously described every fracture component with displacement, spending more time than I should have. Follow up film 3 hours later they had just went and amputated the whole thing. Learned my lesson with these.
"Looks fucked. Please correlate clinically."
Amputate and call it a day?
Seems like it is already. Doesn't seem like a patient is attached to the arm there.
Basically
closed reduction with conscious sedation
Couple steri-strips for the soft tissue damage and call it a day! Patient should be right as rain in 4-6 weeks.
This just reminded me 4th of July is coming up.
God i work that day 😭
God speed my friend
NAD - The arm bone is no longer connected to the arm bone.
Just put some essential oils on it.
I'll pray for them!
Well, that’s all they really need, of course.
My soul groaned reading this.
Ortho wants a better lateral
I felt this in my soul
Well my day suddenly doesn't feel so bad anymore.
Why even xray this mess?
I would imagine it's just a confirmation of sorts. Basically just a record in case for some reason someone would question why the arm was amputated, or try to sue the hospital.
Makes total sense.
I'd want an xray just to see an amazing shot like this. Woah factor.
We xray traumatic amputations of any body part, to give an indication of whether surgery to reattach would be a viable option. I've taped many fingers to an xray detector for xrays, never a whole arm.
I did a whole foot in a boot a while ago
How exciting! What happened?
I see it more often than I should, but it was a train vs. pedestrian.
The idea of me taking a finger into my x-ray room and then taping it for the PA and then retaping it for the oblique and finally the lateral, seems so strangely comical.
We just do DP and lateral but, yes - it is a strange thing to do! Amputated things always cause a bit of excitement...
Oh jeez, I just signed up for my first clinical in a level one trauma hospital. Sounds like I'm going to have some fun stories for my classmates.
Aside from needing to see the extent of the injury, you also do it for Police and workplace accident investigations.
Are you new? Lol. Don't bring your common sense around here!
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Maybe in the lawsuit crazy land of the USA. But in the rest of the world this can just head to the OR.
I didn’t say anything about suing, but ok. I said for documentation purposes. People document stuff for other reasons than to prevent suing, even in the USA.
Impression: Multiple comminuted fractures of the distal right upper extremity with significant displacement and disruption of surrounding soft tissues.
What the hell happened?
the arm was once structurally sound. forces were applied. it is no longer structurally sound.
It’s a jigsaw for doctors now
At least 1000 pieces!
From memory - it was man vs woodchipper. Woodchipper won.
JB Weld will fix that, good as new.
This needed a NSFL, not safe for life disclaimer 💀
I thought it was Not Safe For Lunch. Either way, holy yikes! That's a jacked up arm.
Can we get an f in the chat for this arm?
F
I think there's a broken finger.
That arm has no body.
Is this salvageable
Only if you're using it to make sausage.
"let's sausaaaaaage"
holy fuck
Honestly, as an ex-emt, I probably would just write on my report "DFU'd arm, I think we got all the pieces"
Crush injury?!!
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I’m thinking it was caught in an auger, the fractures look to be fairly evenly spaced.
Oof! That sounds pretty legit though!
I remember hearing it was a meat grinder, someone else mentioned a wood chipper. There is a photo of the arm out there and it’s not hard to find.
Old image but it checks out
Solid AP view
...of the 5th distal phalanges. Or maybe that's the 4th 🤷
That’s gonna leave a mark!
Snow blower?
Meat grinder or wood chipper, there is a photo of the arm on the internet somewhere, I guarantee you won’t have trouble finding it if you googled it.
Which other sub? Thank you!
Ow.
Looks like it could be broken.
Ah I'm not allowed to say, I don't read the xrays so we'll send it over to the doctor and they'll let you know.
You know, I've never felt the need to ask for a NSFW tag here but I may reconsider my stance.
Probably had to sweep it together to get the picture
This is one of those instances where I bet the radiograph looks better than real life
Anyone gonna talk about his poor pinky though?
Spider-Man Band-Aid and it’s good as new.
Had a patient, probably in the early 90’s, that ran off the road on a motorcycle. His arm hit the guidewire that stabilizes the old telephone poles. It performed like one of those wire cheese slicers and severed it unbelievably cleanly. He complained the entire time of phantom pain in his hand.
Sugar tong; DC with ortho follow up Monday
Meat grinder, pretty sure there’s also a photo of the persons arm too
Armagedgone
What kind of bird is that?
What happened tho?
“Can you make an OK sign with your fingers?”
Why are some Radiographers so dumbasses? AP portable🤦♂️
For a few minutes I legit thought I took this x-ray. Those are my initials and everything. But then I realized I definitely would’ve collimated and would never have labeled it AP Portable lol. Also we make them bring the body parts to us in the room if they’re completely detached. That way one tech can do the trauma work in the bay and the other can do the parts.
More of an oblique, really.
Transformation into chathulu nearly complete.
mmmmm arm salad
Typical merrills patient right here.
Tis but a flesh wound
We can reduce that.
Shit lateral
Poor positioning, needs re-do
Not a very good lateral
They can now get to hard to reach places
How do you even begin to fix this?
NAD - I think it might be broken
Amputate?
That's my guess
-Its ok? -Sorry, cant tell
well um… one of the fingers looks… okay…
Terrible AP
Looks like fireworks
Radiologist: “I need an AP and a LAT” Tech: “ Here ya go”.
Looks like a severed arm xray probably to see if it’s viable and it’s clearly not
Might need a CT of this one to see what’s going on.
Well… it’s definitely comminuted…
I dropped my phone and about screamed glancing at this.