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51 Cards in this Set
- Front
- Back
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What are the 3 Wrist Views? |
PA: carpalarcuate lines, ulnar variance, radial articular angle Lateral: radiusvolar tilt, scapolunate & capitolunate angle Oblique: radialside carpals & hamate |
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What are the three Hand Views |
PA:phalanges, metacarpals, carpals Lateral:radius, lunate, capitate, 3rdmetacarpal within 10⁰ of each other Oblique:shows hand long bones without superimpositionB |
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Ulnar deviation View |
Shoes scaphpoid and adjacent joint spaces |
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Radial deviation view |
shows ulnar side carpals and intercarpal spaces |
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Capral tunnel view |
Shows arched carpals on palmar |
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Stress views |
Reveal instabilities |
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Terry Thomas Sign |
Subluxation of the scaphpoid boe with widening between the scaphoid and lunate |
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What are Gilula arcs |
alignment described on posteroanterior or anteroposterior wrist radiographs and are used to assess normal alignment of the carpus |
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What are the 3 gilula arcs |
First: smooth curve outlining the proximal convexities of the scaphoid lunate and triquetrum Secondarc: tracesthe distal concave surfaces of the same bones Thirdarc: follows the main proximal curvatures of the capitate and hamate |
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What to assess in Oblique wrist view |
Trapezium and articulations
Radial and ulnar styloids |
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Lateral Wrist and Hand assessement |
Long axes of 3rd MC, cap, lun, and radial align within 10 Lunate and radius should be parallel Lunate > 15 toward palm = volar intercalated segmental instability Lunate extended > 10 = Dorsal intercalated segmental instability |
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Normmal Scapholunate angle? |
Average 47 +/- 15
If angle is greater, carpal could be unstable. |
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Normal Capitolunatele angle |
Normally less than 20 Greater than 20 suggests instability |
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Purpose of Tangential inferosuperior view |
View carpal sulcus to identify abnormalities that may be compressing the median nerve or flexor tendons |
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What is advanced imaging used for |
Diagnosing scaphoid fractures |
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Fracture of distal 5th metacarpal |
Boxer's Fracture |
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Common Hand fractures |
Distal Ph - crushing injuries Metacarpal and Phal - Desc by location -Avulsion Fx at tendon/lig attachment Thumb - Freq at base: intra or extra-articular |
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Consquences of Scaphoid fracture |
Blood supply of scaphoid is distal which means that if the Fx is at the middle or proximal part, avascular necrosis may occur |
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What is a colles fx |
extra-articular fx about 1.5 inches proximal to the wrist with dorsal displacement |
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What is a Barton Fx |
Fx dislocation of the distal radius and radiocarpal joint. (pointed tips) |
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What is a Die Punch fracture |
Lunate is driven into the radius causing articular damage at the radiocarpal joint |
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Standard care of a Fx |
Treat it like a Fx if uncertain - Immobilize Radiograph - and if inconclusive - repeat in one week |
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Common Distal Radius Fractures |
Adults - Colles Young Adults - Die Punch Kids - Most common fx - heals well |
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Classifications of Wrist Instability |
–Predynamic:no radiologic abnormalities –Dynamic:seen only on functional radiographs, stress views, or cineradiography –Static:seen on conventional radiographs |
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What is Cineradiography |
a motion study at the wrist and is used to assess dynamic instability Pt moves wrist back and forth between radial and ulnar deviation to reproduce clicking and snappinf |
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What are the 3 types of carpal instabilities |
–Carpalinstability dissociative (CID) –Carpalinstability nondissociative (CIND) –Carpalinstability combined (CIC) |
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What is wrist imaging significant for |
Identify extent of pathology Exclude differential dx Precise dx to direct tx Provide an informed prognosis |
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What can assess the wrist alignment |
Radiographs, Ct, Functional Radiograph |
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What can asses ligamentous lesions |
Arthrography, MRI, MRI -artho, CT -arthro |
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What are the two types of instablity |
Distal radioulnar joint Between Carpal rows/each bones |
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What is a perilunate dislocation |
dislocation of the capitate to the lunate |
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What is the Triangular Fibrocartilage complex? |
Isan important stabilizer of the distal radioulnar joint, and may be torn byitself or in combination with other injuries. |
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How to Dx Carpal tunnel? |
Electromyography and nerve conduction velocity and advanced imaging |
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What is the TFCC |
Major stabilizer of the ulnar carpus and DRUJ Absorbs 20% of the axail load of the wrisst |
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What does the TFCC consist of |
Radiotriquetral lig Articular disk ECU tendon sheath Palmar and radioulnar lig Ulnocarpal lig/meniscus |
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What is Arthritides |
DJD common after age 50 Signs include decreased joint space, sclerosis, and osteophytosis |
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Types of Arthitides |
Heberden's Nodes" Distal Phalanx Bouchards: Proximal phalanx Basal Joint Arthritis at 1st MCP joint RA can be seen at wrist, MCP, and proximal IP Joints |
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Hallmarks for RA |
Uniform joint space narrowing Periarticular rarfaction Articular erosions Synovial cysts Joint deformities (swan and boutonniere) |
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Scapholunate Dislocation - Terry Thomas Sign |
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PA View |
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Oblique View |
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Lateral View |
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Ulnar Deviation |
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Radial Deviation |
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Carpal Tunnel View |
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Gamekeepers Bennetts Fracture |
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Colles Fracture |
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Die Punch Fracture |
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Boxer's Fracture |
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Heberden's Nodes (DIP) Bouchard's Nodes (PIP) |
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Perilunate Dislocation |
