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 extremity wrist

Upper ExtremityWRIST

RTEC 123

# 1B LECTURE

Contributions by:

MOSBY – MERRILLS & BONTAGER

XRAY2000.CO.UK rev 10/10/11


Anatomy review

ANATOMY REVIEW

WRIST


Upper extremity wrist

S

L

T

P

T

T

C

H


Test yourself

TEST YOURSELF


Www rad washington edu

www.rad.washington.edu


Upper extremity wrist

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 ! ↑


Upper extremity wrist

PA vs AP WRIST


Pa oblique wrist

PA OBLIQUE WRIST


Pa oblique

PA OBLIQUE


Pa oblique1

PA OBLIQUE


Ap oblique wrist

AP OBLIQUE WRIST


Alternate positioning for obliques

Alternate positioning for obliques


These are the same position on the image

THESE ARETHE SAMEPOSITIONON THE IMAGE

PA OBLIQ / AP OBLIQ : LAT ROTATION


Which oblique what is seen

Which Oblique & What is seen?


Oblique wrist pa obl lat rot ap obliq med rot

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


Pa oblique ap oblique

PA Oblique / AP Oblique


True lateral

“true” Lateral


Upper extremity wrist

MOST COMMONLY FX CARPAL BONE


Scaphoid

SCAPHOID


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”


Upper extremity wrist

43


Pathology for upper extremity 1

PATHOLOGYFOR UPPER EXTREMITY 1

SEE CHART PG ______

Avulsion fx

Bone cyst

Bursitis

fractures

Joint effusion

Osteoporosis

Rheumatoid Arthritis


Upper extremity wrist

AP/LAT wrist

showing complete dislocation of the lunate


Upper extremity wrist

Fracture type?


Fracture type

Fracture type?

What else should be done?


Problem path

Problem/ Path?


Greenstick

greenstick


Torus or buckle

Impacted

fracture with

bulging of the periosteum.

Torus or Buckle

50


Upper extremity wrist

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

impacted

52


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


Scaphoid fx

SCAPHOID FX


Upper extremity wrist

57


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


Upper extremity wrist

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

  • of the distal radius and ulnar styloid

  • with anterior displacement.


Smith s fx

SMITH’S FX

Flexion-Compression

FX WITH

ANTERIOR

DISPLACEMENT


Smith s fx1

Smith’s FX


Barton 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 vs Barton’s


Colles fracture2

Colles' fracture?

70


Www rad washington edu1

www.rad.washington.edu


Upper extremity wrist

QUESTIONS ?

OPEN LABS SIGN UP

? Days TBA

NOTE: NO OPEN LABS BEFORE I DO DEMONSTRATIONS


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