upper extremity wrist
DESCRIPTION
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 - PowerPoint PPT PresentationTRANSCRIPT
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Upper ExtremityWRIST
RTEC 123 # 1B LECTURE
Contributions by:MOSBY – MERRILLS & BONTAGER
XRAY2000.CO.UK rev 10/10/11
2ANATOMY REVIEWWRIST
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5TEST YOURSELF
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7www.rad.washington.edu
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•Use a FULL SHIELD
•PROTECT THE BREAST & THYROID
•HAVE PATIENT TURN THEIR HEAD
POSITIONING
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WRIST (5)
• PA
• OBLIQUE (MEDIAL)- PA OBLIQUE
• LATERAL
• OBLIQUE (LATERAL) AP OBLIQUE
• ULNAR DEVIATION (SCAPHOID “view”)
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Note incorrect position of patient ! ↑
PA WRIST
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14PA vs AP WRIST
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PA OBLIQUE WRIST
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PA OBLIQUE
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PA OBLIQUE
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AP OBLIQUE WRIST
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Alternate positioning for obliques
21THESE ARETHE SAME POSITIONON THE IMAGE
PA OBLIQ / AP OBLIQ : LAT ROTATION
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Which Oblique & What is seen?
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OBLIQUE WRISTPA OBL (LAT ROT) / AP OBLIQ (MED ROT)
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PA Oblique / AP Oblique
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“true” Lateral
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MOST COMMONLY FX CARPAL BONE
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SCAPHOID
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When the hand is turned toward the ulnar side, it is termed:
• A. adduction
• B. abduction
• C. ulnar deviation
• D. radial deviation
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When the hand is turned toward the ulnar side, it is termed:
• A. adduction
• B. abduction
• C. ulnar deviation
• D. radial deviation
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ADDITONAL VIEWS - WRIST
• CARPAL CANAL
• LECTURE ONLY –
• NOT FOR LAB PRACTICE
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41CRITIQUEWRIST
Digital “issues”
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PATHOLOGYFOR UPPER EXTREMITY 1
SEE CHART PG ______
Avulsion fx
Bone cyst
Bursitis
fractures
Joint effusion
Osteoporosis
Rheumatoid Arthritis
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AP/LAT wrist
showing complete dislocation of the lunate
46Fracture type?
Fracture type? 47
What else should be done?
Problem/ Path?48
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greenstick
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Torus or Buckle
Impacted fracture with
bulging of the periosteum.
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51This 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.
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impacted52
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scaphoid
• If the fracture is not recognized early, it may not heal properly. This can lead to problems later.
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54Scaphoid fxnew 3 wks later
55SCAPHOID FX
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Colles’ Fracture Extension-Compression Fracture of Distal Radius
FX WITH
POSTERIOR
DISPLACEMENT
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Colles' fracture
• of the distal radius and ulnar styloid
• with posterior displacement
• (of the hand)
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Colle's fractures usually occur when an adult falls on a hyperextended, outstretched hand.
There is frequently an associated fracture of the ulnar styloid.
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• Smith's fracture is caused by a fall on a hyperflexed, outstretched hand.
• It is sometimes referred to as a "reverse Colle's fracture."
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Smith's fracture
• of the distal radius and ulnar styloid
• with anterior displacement.
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SMITH’S FXFlexion-Compression
FX WITH
ANTERIOR
DISPLACEMENT
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Smith’s FX
BARTON’S fx68
FX/DISLOCATIONOF 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’s69
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Colles' fracture?
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QUESTIONS ?
OPEN LABS SIGN UP
? Days TBA
NOTE: NO OPEN LABS BEFORE I DO
DEMONSTRATIONS