upper extremity wrist - fisiokinesiterapia · • colle's fractures usually occur when an...

Upper ExtremityWRIST

ANATOMY REVIEW

WRIST

S

L

T

P

T

T

C

H

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."