Diagnosis of Orthopedic Fractures Using Craniodorsal-Caudoventral Oblique and Caudodorsal-Cranioventral Oblique Radiographic Views Made at 45° to the Frontal Plane in Four Wild Turtles
Four wild chelonians (two three-toed box turtles [Terrapene triunguis] and two red-eared sliders [Trachemys scripta elegans]) were presented to an academic wildlife rehabilitation center after presumably being hit by a car. Physical examinations revealed various carapace, bridge, and plastron fractures, as well as a lack of motor function of different limbs. A craniodorsal-caudoventral oblique view or caudodorsal-cranioventral oblique radiographic view made at 45° to the frontal plane (Cr45D-CdV and Cd45D-CrV oblique views, respectively), along with standard views (i.e., dorsoventral, right lateral, craniocaudal views), were performed. The oblique views allowed for visualization of different pectoral girdle or pelvic girdle fractures that were not visualized or clearly identified on the standard views. Based on the four clinical cases described here, the addition of Cr45D-CdV or Cd45D-CrV oblique views to the standard views may be beneficial, especially when advance imaging such as computed tomography is not available. These oblique views can be used to better assess chelonian pectoral and pelvic girdles because these structures are superimposed in standard radiographs. Future studies investigating the diagnostic accuracy of detecting pelvic and pectoral girdle fractures using these views are warranted.Abstract
Anatomy of the chelonian pectoral and pelvic girdles from (A) ventral and (B) lateral points of view.
Graphic depiction of a craniodorsal-caudoventral oblique radiographic view made at 45° to the frontal plane (Cr45D-CdV) for assessment of the thoracic and pelvic girdles of chelonians. The turtle is placed directly onto the plate in ventral recumbency. The x-ray beam is set to 45° to the plate with the beam directed caudally. The machine is placed 100 cm (40 in) from the plate and the beam collimated appropriately around the animal. (A) Position of the animal in relation to the x-ray generator. (B) Close-up showing the placement of the generator crosshairs.
Radiographic views of a three-toed box turtle (Terrapene triunguis) with traumatic injuries (Case 1). Suspected left coracoid and acromion fractures at the glenoid junction can be seen in both images. (A) Dorsoventral and (B) craniodorsal-caudoventral oblique made at 45° to the frontal plane (Cr45D-CdV). White arrow: acromion; white arrowhead: scapula; patterned arrow: coracoid; asterisk: fracture site.
Caudodorsal-cranioventral oblique radiographic view made at 45° to the frontal plane (Cd45D-CrV) for assessment of the thoracic and pelvic girdles of chelonians. Animal used in this figure is not described in this case series. The turtle was placed directly onto the plate in ventral recumbency, and the x-ray beam was set to 45° to the plate with the beam directed cranially. The machine was placed 100 cm (40 in) from the plate and the beam collimated appropriately around the animal. (A) Position of the animal in relation to the x-ray generator. (B) Close-up showing the placement of the generator crosshairs.
(A) Dorsoventral and (B) craniodorsal-caudoventral oblique made at 45° to the frontal plane (Cr45D-CdV) radiographic views of a red-eared slider (Trachemys scripta elegans) with traumatic injuries (Case 2). Fractures of the left and right scapula can be seen in both images. White arrow: acromion; white arrowhead: scapula; patterned arrow: coracoid; asterisk: fracture site.
(A) Dorsoventral (DV) and (B) craniodorsal-caudoventral oblique made at 45° to the frontal plane (Cr45D-CdV) radiographic views of a three-toed box turtle (Terrapene triunguis) with traumatic injuries (Case 3). The fractures of the left and right scapula are well defined on the Cr45D-CdV image when compared with the DV. White arrow: acromion; white arrowhead: scapula; patterned arrow: coracoid; asterisk: fracture site.
(A) Dorsoventral (DV) and (B) craniodorsal-caudoventral oblique made at 45° to the frontal plane (Cr45D-CdV) radiographic views of a red-eared slider (Trachemys scripta elegans) with traumatic injuries (Case 4). A short oblique fracture in the right ilium at the mid-diaphysis can be seen clearly on the Cr45D-CdV view but not on the DV view. White arrow: pubis; patterned arrow: ischium; white arrowhead: ilium; asterisk: fracture site.
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