Imaging of Wrist Trauma
This chapter will principally describe and illustrate acute bony injuries of the distal radius and carpus occurring as a result of trauma. Plain films form the bulk of investigations, but where indicated use of CT and MR imaging is also included. Chronic
- PDF / 3,355,204 Bytes
- 29 Pages / 547.087 x 737.008 pts Page_size
- 92 Downloads / 210 Views
Contents
Abstract
1 1.1 1.2 1.3
Introduction.............................................................. Radiographic Anatomy and Projections ................... Analysis of Radiographs ........................................... Ligamentous Anatomy of Wrist ...............................
141 141 141 143
2 2.1 2.2 2.3
Injuries of Radius and Ulna................................... Children...................................................................... Adults......................................................................... Distal Radio-Ulnar joint............................................
144 144 146 149
3 3.1 3.2 3.3
Carpal Injuries......................................................... Scaphoid..................................................................... Other Carpal Fractures .............................................. Carpal Dislocations ...................................................
151 151 156 158
4
Carpo-Metacarpal Injuries..................................... 162
5
Acute Soft Tissue Injuries ...................................... 163
6
Chronic/Overuse Injuries ....................................... 165
7
Summary/Key Points............................................... 166
References.......................................................................... 167
This chapter will principally describe and illustrate acute bony injuries of the distal radius and carpus occurring as a result of trauma. Plain films form the bulk of investigations, but where indicated use of CT and MR imaging is also included. Chronic traumatic injuries principally overuse, or stress injuries will also be considered but in less detail.
1
Introduction
1.1
Radiographic Anatomy and Projections
Standard radiographic views for the evaluation of wrist are a postero-antererior (PA) and lateral. These projections are described with the relevant anatomy in Radiography and Arthrography and will not be repeated here. These 2 views will allow evaluation of injuries of the distal radius and ulna, an assessment of the carpal bones, and the carpo-metacarpal junction. Additional views may be obtained in special specific circumstance most commonly when there is clinical suspicion of a scaphoid fracture.
1.2
N. Raby (&) Department of Radiology, Westen Infirmary, Glasgow, G11 6NT, UK e-mail: [email protected]; [email protected]
Analysis of Radiographs
On the PA view, inspect each bone in turn looking for cortical disruption that would indicate a fracture. It is important to consider in turn the distal radius and ulna, then the eight carpal bones and finally the bases of the metacarpals. Next, undertake scrutiny of the normal uniform spacing of 1–2 mm around each carpal bone.
A. M. Davis et al. (eds.), Imaging of the Hand and Wrist, Medical Radiology. Diagnostic Imaging, DOI: 10.1007/174_2010_110, Springer-Verlag Berlin Heidelberg 2013
141
142
Fig. 1 a Normal AP radiograph. Note the uniform spacing between the carpal bones including the carpo-metacarpal junction.
Data Loading...
