Wrist And Forearm Injuries Flashcards
What bones form the wrist, forearm and elbow?
(4)
Radius
Ulna
8 carpal bones
Humerus
What are the types of acute injuries for x-rays?
(2)
Fracture
Dislocation
What are the 2 types of fractures?
Non- displaced
Displaced (more than 1cm separation)
Where do dislocations tend to happen in the wrist?
(2)
Radiocarpal bones
Radioulna joint
Where do dislocations tend to happen in the elbow?
Humoulnar
What is an acute injury?
An injury that’s only just happened (it’s usually seen in the emergency department)
What is a dislocation?
Where there’s a complete loss of contact of the articular surface of the joint
What is subluxation?
Partial contact of articular surfaces (partial disruption of joint). Articular surfaces are in tact
Is arthritis an acute or chronic condition?
Chronic
What are common conditions of the wrist?
(5)
Arthritis
Tennis elbow
Rickets
Ganglion
Carpal tunnel syndrome
What is arthritis?
An inflammation of the joint
Who does arthritis mainly affect?
Older people
What is the most common type of arthritis?
Osteoarthritis
What happens in osteoarthritis?
(2)
The cartilage is affected and wears down
The joint space is narrowed
What are the types of arthritis?
(2)
Osteoarthritis
Rheumatoid arthritis
What happens in rheumatoid arthritis?
Immune system targets the affected joint
How does arthritis look like on a hand x-ray?
What are types of chronic conditions seen in the wrist?
(4)
Tennis elbow (injury to lateral epicondyle- soft tissue)
Rickets
Ganglion (fluid filled cists- they sit above the bone)
Carpal tunnel syndrome
What is an epicondyle?
Soft tissue
What are the standard wrist x-ray views?
PA
Lateral
What are the adapted techniques for a wrist x-ray?
(2)
AP
Horizontal beam lateral (HBL)
When would AP be used as an adapted technique for a wrist x-ray?
If the patient can’t put their hand on the vertical detector
What are common radius and ulna fractures?
(4)
Colle’s fracture
FOOSH injury
Fracture of distal radius with posterior displacement of the distal fragment with dorsal angulation
Dinner fork deformity
What does a dinner fork deformity look like?
If there’s a mid shaft radius and ulna fracture due to direct impact, what should we do?
Limit patient movement during imaging
What do fractures of the radius cause?
The radioulna joint to dislocate
What is a galeazzi fracture-dislocation?
A fracture of the mid/distal radius with associate dislocation/subluxation of the distal radioulna joint
Who do galeazzi fracture-dislocations tend to occur in?
Children
What does a galeazzi fracture-dislocation look like?
What is a monteggia fracture-dislocation?
A fracture of the ulna shaft with an associated dislocation of the radial head at the elbow joint
What does a monteggia fracture-dislocation look like?
What type of fracture is this?
Green stick injury, because the fracture didn’t go all the way through the bone
What are the standard x-ray views for the forearm?
(2)
AP
Lateral
What is the adapted technique for a forearm x-ray?
Horizontal beam lateral (HBL)
What is the most common carpal bone injury?
Scaphoid fracture
What are the features of a scaphoid fracture?
(3)
It makes up 75-90% of all wrist fractures
It’s known as the anatomical snuff box (ASB)
The treatment depends on where in the scaphoid the fracture is
Label the scaphoid:
What should we do when doing scaphoid x-ray views?
(2)
Do 4 views at least
In UHL 5 views plus external oblique
What do scaphoid x-rays taken in UHL look like?
What are the most common carpal bone dislocations?
(2)
Lunate
Perilunate
Where do all carpal bones dislocate from when they dislocate?
The lunate
What are common elbow injuries?
(2)
Supracondylar (fracture above the condyles on the humerus)
Transcondylar
What does a supracondylar fracture on an elbow look like?
What is the most common elbow injury?
Radial head and neck fracture
What does a radial head and neck fracture look like?
How can we tell if there’s an elbow injury on the x-ray image?
The sail signs/fat pad- any gray raised sail at the back of the image means there’s an abnormality. An anterior sail sign/fat pad is often normal
Why does a posterior sail signs/fat pad mean that there’s an abnormality?
Because it means that fluid in the joint capsule builds and pushes the pericapsular fat away from the humerus
