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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

Upper ExtremityWRIST

RTEC 123

# 1B LECTURE

Contributions by:

MOSBY – MERRILLS & BONTAGER

XRAY2000.CO.UK rev 10/10/11



S

L

T

P

T

T

C

H




POSITIONING

  • Use a FULL SHIELD

  • PROTECT THE BREAST & THYROID

  • HAVE PATIENT TURN THEIR HEAD


Wrist 5
WRIST (5)

  • PA

  • OBLIQUE (MEDIAL)- PA OBLIQUE

  • LATERAL

  • OBLIQUE (LATERAL) AP OBLIQUE

  • ULNAR DEVIATION (SCAPHOID “view”)


Pa wrist
PA WRIST

Note incorrect position of patient ! ↑








These are the same position on the image
THESE ARETHE SAMEPOSITIONON THE IMAGE

PA OBLIQ / AP OBLIQ : LAT ROTATION



Oblique wrist pa obl lat rot ap obliq med rot
OBLIQUE WRISTPA OBL (LAT ROT) / AP OBLIQ (MED ROT)






When the hand is turned toward the ulnar side it is termed
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 termed1
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
ADDITONAL VIEWS - WRIST

  • CARPAL CANAL

  • LECTURE ONLY –

  • NOT FOR LAB PRACTICE


Critique

CRITIQUE

WRIST

Digital “issues”



Pathology for upper extremity 1

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?




Torus or buckle

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



Scaphoid1
scaphoid

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

53


Scaphoid fx new 3 wks later
Scaphoid fxnew 3 wks later




Colles fracture

Extension-Compression Fracture of Distal Radius

Colles’ Fracture

FX WITH

POSTERIOR

DISPLACEMENT


Colles fracture1

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
Smith's fracture hyperextended, outstretched hand.

  • of the distal radius and ulnar styloid

  • with anterior displacement.


Smith s fx
SMITH’S FX hyperextended, outstretched hand.

Flexion-Compression

FX WITH

ANTERIOR

DISPLACEMENT


Smith s fx1
Smith’s FX hyperextended, outstretched hand.


Barton s fx
BARTON’S fx hyperextended, outstretched hand.

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 vs Barton’s hyperextended, outstretched hand.


Colles fracture2
Colles' fracture? hyperextended, outstretched hand.

70


Www rad washington edu1
www.rad.washington.edu hyperextended, outstretched hand.


QUESTIONS ? hyperextended, outstretched hand.

OPEN LABS SIGN UP

? Days TBA

NOTE: NO OPEN LABS BEFORE I DO DEMONSTRATIONS


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