Upper Extremity WRIST - Fisiokinesiterapia · • Colle's fractures usually occur when an adult...
Transcript of Upper Extremity WRIST - Fisiokinesiterapia · • Colle's fractures usually occur when an adult...
Upper ExtremityWRIST
ANATOMY REVIEW
WRIST
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TEST YOURSELF
www.rad.washington.edu
POSITIONING
•Use a FULL SHIELD
•PROTECT THE BREAST & THYROID
•HAVE PATIENT TURN THEIR HEAD
WRIST (5)
• PA• OBLIQUE (MEDIAL)- PA OBLIQUE• LATERAL• OBLIQUE (LATERAL) AP OBLIQUE
• ULNAR DEVIATION (SCAPHOID “view”)
Note incorrect position of patient ! ↑
PA WRIST
PA vs AP WRIST
PA OBLIQUE WRIST
PA OBLIQUE
PA OBLIQUE
AP OBLIQUE WRIST
Alternate positioning for obliques
THESE ARETHE SAMEPOSITIONON THE IMAGE
PA OBLIQ / AP OBLIQ : LAT ROTATION
Which Oblique & What is seen?
OBLIQUE WRISTPA OBL (LAT ROT) / AP OBLIQ (MED ROT)
PA Oblique / AP Oblique
MOST COMMONLY FX CARPAL BONE
SCAPHOID
When the hand is turned toward the ulnar side, it is termed:
• A. adduction• B. abduction• C. ulnar deviation• D. radial deviation
When the hand is turned toward the ulnar side, it is termed:
• A. adduction• B. abduction• C. ulnar deviation• D. radial deviation
ADDITONAL VIEWS - WRIST
• CARPAL CANAL • LECTURE ONLY –• NOT FOR LAB PRACTICE
FILM CRITIQUEWRIST
PATHOLOGYFOR UPPER EXTREMITY 1
SEE CHART PG 99
Bone cystBursitis
Joint effusionOsteoporosis
Rheumatoid Arthritis
AP wrist showing complete dislocation of the lunate
Mutilating rheumatoid arthritis.
SCAPHOID FX
Smith’s FX
Colles' fracture
greenstick
Scaphoid fxnew 3 wks later
Colles’ FractureExtension-Compression Fracture of Distal Radius
FX WITH
POSTERIOR
DISPLACEMENT
Colles' fracture• of the distal radius
and ulnar styloid• with posterior
displacement
• (of the hand)
• Colle's fractures usually occur when an adult falls on a hyperextended, outstretched hand.
• There is frequently an associated fracture of the ulnar styloid.
• Although Colle's fractures are not intra-articular fractures, secondary degenerative arthritis may develop at the wrist joint.
Smith's fracture• of the distal radius
and ulnar styloid• with anterior
displacement.
SMITH’S FXFlexion-Compression
FX WITH
ANTERIOR
DISPLACEMENT
• This is a Smith's fracture and is caused by a fall on a hyperflexed, outstretched hand.
• It is sometimes referred to as a "reverse Colle's fracture."