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

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

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

2 2 ANATOMY REVIEW WRIST

3 3

4 4 SLTPTTCHSLTPTTCH

5 5 TEST YOURSELF

6 6

7 7

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

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

10 10

11 11 Note incorrect position of patient ! ↑ PA WRIST

12 12

13 13

14 14 PA vs AP WRIST

15 15 PA OBLIQUE WRIST

16 16 PA OBLIQUE

17 17 PA OBLIQUE

18 18 AP OBLIQUE WRIST

19 19

20 20 Alternate positioning for obliques

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

22 22 Which Oblique & What is seen?

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

24 24 PA Oblique / AP Oblique

25 25

26 26

27 27 “true” Lateral

28 28

29 29

30 30

31 31

32 32 MOST COMMONLY FX CARPAL BONE

33 33 SCAPHOID

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

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

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

37 37

38 38

39 39

40 40

41 41 CRITIQUE WRIST Digital “issues”

42 42

43 43

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

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

46 46 Fracture type?

47 47 What else should be done?

48 Problem/ Path? 48

49 49 greenstick

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

51 51 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 53 scaphoid If the fracture is not recognized early, it may not heal properly. This can lead to problems later. 53

54 54 Scaphoid fx new 3 wks later

55 55 SCAPHOID FX

56 56

57 57

58 58

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

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

61 61

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. 62 Smith's fracture is caused by a fall on a hyperflexed, outstretched hand. It is sometimes referred to as a "reverse Colle's fracture."

63 63

64 64

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

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

67 67 Smith’s FX

68 BARTON’S fx 68 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 69

70 70 Colles' fracture? 70

71 71

72 72

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


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