Hand/wrist Imaging Flashcards
What wrist view is used to look for scapholunate widening ?
Clenched fist view
What’s the main indication for MRI in the wrist/hand?
Scaphoid # in a child
What is the initial management and imaging for a suspected scaphoid # ?
Scaphoid splint and repeat radiographs in 7-14 days - high sensitivity and specificity
How do we check alignment of a wrist X-ray ? (3)
- Equal concavity of each side of shaft of proximal metacarpals
- Near equal distance between proximal MC’s (bases will overlap)
- Separation of the distal radius and ulna is present - may be minimal superimposition
The radial styloid should be how much longer than the ulnar articular surface?
9-12mm
What is ulnar variance and how is it measured
The length of the distal ulnar relative to the distal radius
You measure the articular surface of ulnar and the radial styloid, which should be 9-12 mm longer
What is ulnar positive ?
Ulnar is longer than should be
What is ulna negative ?
Ulnar shortened at the wrist joint
What’s one way to assess rotation of metacarpal fractures
Make a fist in supination, all fingers should point towards scaphoid
What type of hand/finger fractures are more associated with rotational deformity ?
Spiral and oblique fractures
How do we check alignment on an oblique hand X-ray? (3)
- The metacarpal mid shafts should not overlap
- The heads of MCP 3 and 4 should slightly overlap
- 2nd MCP should not overlap the third
Alignment of lateral hand x ray? (3)
- Fingers equally separated
- MC superimposed
- Distal radius and ulnar superimposed
What does SNAC stand for ?
Scaphoid non-union and advanced collapse
What does SLAC stand for ?
Scapholunate advanced collapse
What is a Salter Harris type 1 injury
Physis separation
