wrist

Question 1

• Pronate hand.
• Best demonstrate
  individual carpal bone
  fracture.
• Best demonstrate
  scaphoid fat stripe.
• Slightly arch the hand at the MCP joints by flexing the digits to place the wrist in
  close contact with the IR

Answer 1

WRIST PA

Question 2

• Best demonstrate the
  carpals on the lateral
  side of the wrist
  (scaphoid and
  trapezium).
• Best demonstrate the
  anatomic snuff box.
• Pronate the hand.
• Rotate the wrist laterally (externally) at an angle of approximately 45 degrees.

Answer 2

WRIST PA OBLIQUE

Question 3

• Best demonstrate the
  carpals on the medial
  side of the wrist.
• Best demonstrates the
  pisiform

Answer 3

WRIST AP OBLIQUE

Question 4

• Best demonstrate the
  pronator fat stripe
• Best demonstrate
  widening of the wrist joint
  due to fracture or
  dislocation.
• Good projection to
  assess the relationship
  of capitate, lunate and
  distal radius (normally
  in a straight line).

Answer 4

WRIST LATERAL

Question 5

• Pronate hand
• Have patient evert (turn
  outward) hand as far as
  can be rotated.
• Best demonstrate
  fractures of the
  scaphoid.

Answer 5

PA WRIST ULNAR DEVIATION

Question 6

• Have patient invert (turn
  inward) hand as far as
  can be rotated.
• Best demonstrate the
  joint spaces on the
  medial carpals or the
  ulnar side of the wrist.
• Best demonstrate the
  lunate, triquetrum,
  pisiform and hamate.

Answer 6

PA WRIST PROJECTION
RADIAL DEVIATION

Question 7

• Hold wrist & evert (turn
  outward) on ulnar side.
• Place hand & wrist palm
  down with hand
  elevated 20 degrees
  angle on sponge.

Answer 7

WRIST PA SCAPHOID
STETCHER METHOD

Question 8

• Best demonstrate
  fractures of the scaphoid.
• Alternative method for
  wrist ulnar deviation
  with CR angulation.
• CR 20 degrees towards
  elbow.

Answer 8

BRIDGEMAN VIEW

Question 9

Best demonstrate
scaphoid fractures
using a four image
multiple angle central
ray series.

Answer 9

SCAPHOID SERIES
RAFERT-LONG METHOD
ULNAR DEVIATION

Question 10

• Place a 45 degrees
  sponge against anterior
  surface & rotate hand to
  place in contact with
  sponge
• Hand in ulnar flexion
• CR 45° distally to enter
  the anatomic snuff box of
  the wrist and pass
  through the trapezium
• Best demonstrate
  trapezium fractures
• Best demonstrate
  articular surface of the
  trapezium to treat
  osteoarthritic patient.

Answer 10

CLEMENTS-NAKAYAMA METHOD
PA AXIAL OBLIQUE PROJECTION

Question 11

• Have patient hyperextend
  wrist (dorsiflex) by
  elevating hand
• CR 25°-30° to the long
  axis of the hand.
• Best demonstrate the
  palmar aspect of the
  carpal known as carpal
  tunnel or canal.

Answer 11

CARPAL CANAL/TUNNEL
TANGENTIAL, INFEROSUPERIOR PROJECTION
GAYNOR-HART METHOD

Question 12

Hand & forearm forms as
near a 90 degrees angle.
* Demonstrate any
calcification and foreign
body in the dorsal aspect
of the carpal bones.

Answer 12

CARPAL BRIDGE
TANGENTIAL PROJECTION