1. MOSBY – MERRILLS & BONTAGER
Upper Extremity WRIST
RTEC 123
# 1B LECTURE
Contributions by:
MOSBY – MERRILLS & BONTAGER
XRAY2000.CO.UK rev 10/10/11

2. ANATOMY REVIEW
WRIST

4. S L T P C H

5. TEST YOURSELF

8. POSITIONING Use a FULL SHIELD PROTECT THE BREAST & THYROID
HAVE PATIENT TURN THEIR HEAD

9. WRIST (5) PA OBLIQUE (MEDIAL)- PA OBLIQUE LATERAL
OBLIQUE (LATERAL) AP OBLIQUE
ULNAR DEVIATION (SCAPHOID “view”)

11. PA WRIST
Note incorrect position of patient ! ↑

14. PA vs AP WRIST

15. PA OBLIQUE WRIST

16. PA OBLIQUE

17. PA OBLIQUE

18. AP OBLIQUE WRIST

20. Alternate positioning for obliques

21. THESE ARE THE SAME POSITION ON THE IMAGE
PA OBLIQ / AP OBLIQ : LAT ROTATION

22. Which Oblique & What is seen?

23. OBLIQUE WRIST PA OBL (LAT ROT) / AP OBLIQ (MED ROT)

24. PA Oblique / AP Oblique

27. “true” Lateral

32. MOST COMMONLY FX CARPAL BONE

33. SCAPHOID

34. When the hand is turned toward the ulnar side, it is termed:
A. adduction
B. abduction
C. ulnar deviation
D. radial deviation

35. When the hand is turned toward the ulnar side, it is termed:
A. adduction
B. abduction
C. ulnar deviation
D. radial deviation

36. ADDITONAL VIEWS - WRIST
CARPAL CANAL
LECTURE ONLY –
NOT FOR LAB PRACTICE

41. CRITIQUE
WRIST
Digital “issues”

43. 43

44. PATHOLOGY FOR UPPER EXTREMITY 1
SEE CHART PG ______
Avulsion fx
Bone cyst
Bursitis
fractures
Joint effusion
Osteoporosis
Rheumatoid Arthritis

45. AP/LAT wrist
showing complete dislocation of the lunate

46. Fracture type?

47. Fracture type?
What else should be done?

48. Problem/ Path?

49. greenstick

50. Torus or Buckle
Impacted
fracture with
bulging of the periosteum. 50

51. This fracture is most common in children between the ages of 5 and 11
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

52. impacted 52

53. scaphoid
If the fracture is not recognized early, it may not heal properly. This can lead to problems later. 53

54. Scaphoid fx new 3 wks later

55. SCAPHOID FX

57. 57

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

60. Colles' fracture of the distal radius and ulnar styloid
with posterior displacement
(of the hand)

62. 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."

65. Smith's fracture of the distal radius and ulnar styloid
with anterior displacement.

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

67. Smith’s FX

68. 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

69. Colles vs Barton’s

70. Colles' fracture? 70

73. QUESTIONS ? OPEN LABS SIGN UP ? Days TBA
NOTE: NO OPEN LABS BEFORE I DO DEMONSTRATIONS