1. Upper extremity week 9 lecture #3-A PATHOLOGY & POSITIONING1
Upper extremity week 9 lecture #3-A PATHOLOGY & POSITIONING
RT 123 FALL 2011 REVISED

2. 2
Position? Taken For ?
Bilateral Oblique – “ball cathers” taken for arthritis

3. 3

4. Why the digits need to stay parallel to the IR4

5. A-
SHOWS
INSUFFICIENT
ROTATION
What is the criteria to decide? 5

6. 6
Problem ?
Look at wrist and elbow - why was this taken this way?

7. What pathology do you see (look at distal end)7

8. 8
B- OVER FLEXED, HAND NOT LATERAL (ROTATION)

9. 9 NOTE – epicondyles not completely superimposed
Why? Humerus is not // to IR 9

10. Positions?
What needs to be corrected on the image on your RIGHT? 10

11. 11
Age? Positioning?
How can you determine the childs age?

12. Any corrections needed?12

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14. 14

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16. 16

17. 17

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19. 19

20. Image review from Elsevier20
Image review from Elsevier
Fall 2008

21. Acceptable for scaphoid?
Why or why not 21

22. 22

23. Positioning error? 23

24. The separation of the proximal radius and ulna indicates that the elbow was rotated from a true AP projection 24

25. and the elbow is extended beyond 90°.
The humerus and forearm are not in the same parallel plane to the IR (epi’s)
and the elbow is extended beyond 90°.
(?) 25

26. 26

27. 27
PATHOLOGY

28. ? fx
boxers 28

29. 29

30. 30 ?
                                          <>
bennetts

31. Bennett's fracture 31 is caused by forced abduction of the thumb
there is a dislocation of the base of the first metacarpal although a fragment continues to articulate with the trapezium.
                                          <>
bennetts

32. Rheumatoid Osteo Arthritis32
Rheumatoid Osteo Arthritis
RA - inflammatory x more common in women
OA – non- inflammatory joint disease – involves the articular cartilage

33. 33
RHEUMATOID ARTHRITIS

34. Rheumatoid arthritis RA - inflammatory disease
3x more common in females

35. Osteoarthritis of fingers
Osteoarthritis of fingers. Note narrowing of interphalangeal joints with spurring and erosions
OA - Non inflammatory joint disease involves the articular cartilage –
Aging /erosion

36. 36

37. Transradial styloid perilunate fracture-dislocation37
Transradial styloid perilunate fracture-dislocation

38. Fracture of the trapezium (greater multangular)38

39. 39
greenstick

40. Torus /buckle fx 40

41. Torus or Buckle
Impacted
fracture with
bulging of the periosteum. 41

42. Which carpel bone is the most common for fracture?42

43. 43

44. Colles’ Fracture Extension-Compression Fracture of Distal Radius
FX WITH
POSTERIOR
DISPLACEMENT 44

45. ?
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46. 46

47. SMITH’S FX
Flexion-Compression
FX WITH
ANTERIOR
DISPLACEMENT 47

48. 48

49. Colle's fractures usually occur when an adult falls on a hyperextended, outstretched hand.
There is frequently an associated fracture of the ulnar styloid.
Secondary degenerative arthritis may develop at the wrist joint.
Same as Colles except there is volar displacement and angulation of the distal fragment

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51. 51

52. Fat pad sign w elbow injury52

53. 5yo fell off swingset not 90º flexed53

54. Monteggia fracture- disclocation of radial head and displaced fx of ulnar shaft54

55. 55

56. 56

57. Subtle radial head fx 57

58. A swollen elbow usually contains a fracture injury
A swollen elbow usually contains a fracture injury. In some instances, a joint effusion (posterior fat pad sign or enlarged anterior fat pad sign) can be seen in the absence of a visible fracture. 58

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60. 60

61. 61
the other oblique view shows an obvious fracture of the lateral (external) condyle.

62. Lateral condlye fx 62

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64. 64

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66. 66

67. SIMPLE BONE CYST 67

68. Practice in LAB SIGN UP = MONDAY TUESDAY WED – NOTE:
NO LAB BEFORE DEMOS…. 68