Learning objectives
Review the anatomy of the wrist.
Recognize the clinical presentation of wrist pathologies associated to trauma.
Identify imaging findings of most common acute wrist injuries.
Determine which imaging modality is most appropriate depending on the type of injury.
Background
I.
Introduction
The wrist is a complex joint that forms the bridge between the forearm and hand providing stability,
control and coordinating the movements.
The wrist is composed of eight carpal bones that articulate with the distal radio-ulnar joint (DRUJ) proximally and the base of the metacarpals distally.
The wrist igaments are categorized as intrinsic or as extrinsic.
II.
Anatomy
A.
Carpal Bones
There are two rows of carpal bones.
The proximal row articulate with the DRUJ,
contains the scaphoid,
lunate,
triquetrum and pisiform.
It...
Findings and procedure details
I.
Distal Radius Fracture
In the elderly FOOH is the most common cause of distal radius fractures.
Younger patients may have these fractures but occur in a high energy impact trauma.
When evaluating the AP and lateral views of the wrist it is important to assess for radial height,
radial inclination,
volar tilt,
and intra articular involvement.
If there is wrist dislocation a pre and post reduction films are needed for complete evaluation and to determine definitive treatment 18.
Colles Fracture Fig. 3
Is a...
Conclusion
It is important to have a clear understanding of the anatomy of the wrist when evaluation a patient’s imaging with clinical history of FOOH.
Recognizing the different post-traumatic pathology of a wrist and having at least an idea of the management is important to triage which need to be immediately referred to the orthopedic surgeon and which can be treated nonsurgically.
Last but not less important,
the radiologist must know that some pathology will not be seen in the initial radiographic evaluation and further assessment...
References
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Extrinsic and intrinsic ligaments of the wrist: Normal and pathologic anatomy at MR arthrography with three-compartment enhancement.RadioGraphics,18(3),
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(2018).
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