Upper extremity wrist
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Upper Extremity WRIST. RTEC 123 # 1B LECTURE Contributions by: MOSBY – MERRILLS & BONTAGER XRAY2000.CO.UK rev 10/10/11. ANATOMY REVIEW. WRIST. S L T P T T C H. TEST YOURSELF. www.rad.washington.edu. POSITIONING. Use a FULL SHIELD

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Upper Extremity WRIST

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Upper ExtremityWRIST

RTEC 123

# 1B LECTURE

Contributions by:

MOSBY – MERRILLS & BONTAGER

XRAY2000.CO.UK rev 10/10/11


ANATOMY REVIEW

WRIST


S

L

T

P

T

T

C

H


TEST YOURSELF


www.rad.washington.edu


POSITIONING

  • Use a FULL SHIELD

  • PROTECT THE BREAST & THYROID

  • HAVE PATIENT TURN THEIR HEAD


WRIST (5)

  • PA

  • OBLIQUE (MEDIAL)- PA OBLIQUE

  • LATERAL

  • OBLIQUE (LATERAL) AP OBLIQUE

  • ULNAR DEVIATION (SCAPHOID “view”)


PA WRIST

Note incorrect position of patient ! ↑


PA vs AP WRIST


PA OBLIQUE WRIST


PA OBLIQUE


PA OBLIQUE


AP OBLIQUE WRIST


Alternate positioning for obliques


THESE ARETHE SAMEPOSITIONON THE IMAGE

PA OBLIQ / AP OBLIQ : LAT ROTATION


Which Oblique & What is seen?


OBLIQUE WRISTPA OBL (LAT ROT) / AP OBLIQ (MED ROT)


PA Oblique / AP Oblique


“true” Lateral


MOST COMMONLY FX CARPAL BONE


SCAPHOID


When the hand is turned toward the ulnar side, it is termed:

  • A. adduction

  • B. abduction

  • C. ulnar deviation

  • D. radial deviation


When the hand is turned toward the ulnar side, it is termed:

  • A. adduction

  • B. abduction

  • C. ulnar deviation

  • D. radial deviation


ADDITONAL VIEWS - WRIST

  • CARPAL CANAL

  • LECTURE ONLY –

  • NOT FOR LAB PRACTICE


CRITIQUE

WRIST

Digital “issues”


43


PATHOLOGYFOR UPPER EXTREMITY 1

SEE CHART PG ______

Avulsion fx

Bone cyst

Bursitis

fractures

Joint effusion

Osteoporosis

Rheumatoid Arthritis


AP/LAT wrist

showing complete dislocation of the lunate


Fracture type?


Fracture type?

What else should be done?


Problem/ Path?


greenstick


Impacted

fracture with

bulging of the periosteum.

Torus or Buckle

50


This fracture is most common in children between the ages of 5 and 11. Typically, the child reports having fallen onto his or her outstretched hand.

51


impacted

52


scaphoid

  • If the fracture is not recognized early, it may not heal properly. This can lead to problems later.

53


Scaphoid fxnew 3 wks later


SCAPHOID FX


57


Extension-Compression Fracture of Distal Radius

Colles’ Fracture

FX WITH

POSTERIOR

DISPLACEMENT


of the distal radius and ulnar styloid

with posterior displacement

(of the hand)

Colles' fracture


Colle's fractures usually occur when an adult falls on a hyperextended, outstretched hand.

There is frequently an associated fracture of the ulnar styloid.

  • Smith's fracture is caused by a fall on a hyperflexed, outstretched hand.

  • It is sometimes referred to as a "reverse Colle's fracture."


Smith's fracture

  • of the distal radius and ulnar styloid

  • with anterior displacement.


SMITH’S FX

Flexion-Compression

FX WITH

ANTERIOR

DISPLACEMENT


Smith’s FX


BARTON’S fx

FX/DISLOCATION

OF POSTERIOR LIP OF DISTAL RADIUS

unstable intra-articular fracture of the dorsal lip of the radius with dorsal subluxation of the carpus along with the dorsal radius fragment


Colles vs Barton’s


Colles' fracture?

70


www.rad.washington.edu


QUESTIONS ?

OPEN LABS SIGN UP

? Days TBA

NOTE: NO OPEN LABS BEFORE I DO DEMONSTRATIONS


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