Ankle and Foot 47 - Department of Radiology - University of ...

2274 VII Imaging of the Musculoskeletal System
APC
Figure 47-82. Anterior process of the calcaneus (APC) fracture in a
48-year-old who fell while standing on a picnic table, sustained a
twisting injury to the foot. This lateral radiograph was obtained in the
emergency department the next day. The arrowheads in the magnified
dashed box show the minimally displaced lucent fracture lines through
the APC. The patient did well after nonoperative treatment with a non–
weight-bearing cast for 12 weeks.
A
C
B
D
Figure 47-83. Anterior process of the calcaneus
(APC) fracture in a 29-year-old who tripped down
some steps. A, Oblique, non–weight-bearing foot
radiograph shows a nondisplaced APC fracture (white
arrowheads in magnified dashed box). B, Radiographs
6 months later show that the APC fracture is still
unhealed. CT scans were also obtained on the same
day as the initial radiographs. C, Source axial images
through both hindfeet reveal the minimally displaced
transverse fracture (white arrowheads in dotted
magnified box) of the left APC. The contralateral right
foot serves as a useful normal comparison when both
feet are included in the small scanning field of view.
D, Sagittal reformatted image shows the ACP fracture
disrupting the superior cortex (arrow). The acute
fracture margins are not corticated. The patient was
initially treated conservatively, including 4 months of
non–weight bearing and 4 months with a bone
stimulator. When the patient remained symptomatic
7 months later, a repeat CT scan was requested.
Ch047-A05375.indd 2274
9/9/2008 5:35:21 PM