Wrist

Question 1

Wrist Joint Capsule attachments:

Answer 1

Distal ends of radius and ulna. Proximal ends of Scaphoid Lunate and Triquetrum. Margins of joint disc.

Question 2

Bones which form the wrist joint articulation

Answer 2

Distal end of the radius with the scaphoid and lunate. Articular disc with the lunate & Triquetrum.

Question 3

Supporting ligaments of wrist joint (any two of)

Answer 3

Palmar radio carpal.
Palmar ulno carpal.
Dorsal radio carpal.
Radial collateral.
Ulna collateral.

Question 4

What is the cause ofCarpal Tunnel Syndrome

Answer 4

Compression of median nerve causing damage to nerve OR nerve ischemia (reduced blood flow).

Question 5

Symptoms of carpal tunnel syndrome:

Answer 5

• Numbness (lateral 3.5 digits).
• Pain (worsens at night).
  -Tingling (at night relieved by shaking rubbing working fingers).
• Atrophy/Weakness (thumb muscle).
• Clumsiness (fine motor movements).

Question 6

Causes of carpal tunnel syndrome:

Answer 6

Bony or ligament changes, reducing tunnel capacity.
Swelling, inflammation of tendon, or tumour, increasing volume in tunnel.
Systemic diseases e.g. RA, Diabetes mellitus.
Injury, pregnancy, birth control, or RSI in labourers

Question 7

Colles fracture cause

Answer 7

FOOSH - dinner fork appearance

Question 8

Colles fracture location

Answer 8

Distal end of radius, distal fragment displaced posteriorly. 60% ulna fracture also.

Question 9

Colles fracture type/pattern

Answer 9

Transverse and comminuted. Sharp cortical overlap, some impaction.
Decrease in length

Question 10

Clinical manifestations of Rheumatoid arthritis (appearance):

Answer 10

-Usually bilateral and symmetric involvement of PIP and MCP joints.
-fingers spindle-shaped due to inflamed PIP joint
-subluxation of joints with joint deformities leading to ulnar deviation of fingers (swan neck = hyperextended PIP and flexed DIP)
-fixation of joints (boutonnière = flexed PIP and hyperextended DIP).

Question 11

Scaphoid fracture pattern (appearance)

Answer 11

Often missed initially. Transverse (long axis) through waist (70%) proximal pole (20%) or distal pole(10%). Complications depending on position - avascular necrosis (blood supply cut off). Blood only supplied to distal pole.

Question 12

Pathological characteristics of rheumatoid arthritis

Answer 12

Development of new blood vessels:
Pannus from synovium:
Inflammatory cells:
Margins of joint space:
Irreversible: