Wrist And Forearm Injuries

Question 1

What bones form the wrist, forearm and elbow?
(4)

Answer 1

Radius

Ulna

8 carpal bones

Humerus

Question 2

What are the types of acute injuries for x-rays?
(2)

Answer 2

Fracture

Dislocation

Question 3

What are the 2 types of fractures?

Answer 3

Non- displaced

Displaced (more than 1cm separation)

Question 4

Where do dislocations tend to happen in the wrist?
(2)

Answer 4

Radiocarpal bones

Radioulna joint

Question 6

Where do dislocations tend to happen in the elbow?

Answer 6

Humoulnar

Question 7

What is an acute injury?

Answer 7

An injury that’s only just happened (it’s usually seen in the emergency department)

Question 8

What is a dislocation?

Answer 8

Where there’s a complete loss of contact of the articular surface of the joint

Question 9

What is subluxation?

Answer 9

Partial contact of articular surfaces (partial disruption of joint). Articular surfaces are in tact

Question 10

Is arthritis an acute or chronic condition?

Answer 10

Chronic

Question 11

What are common conditions of the wrist?
(5)

Answer 11

Arthritis

Tennis elbow

Rickets

Ganglion

Carpal tunnel syndrome

Question 12

What is arthritis?

Answer 12

An inflammation of the joint

Question 13

Who does arthritis mainly affect?

Answer 13

Older people

Question 14

What is the most common type of arthritis?

Answer 14

Osteoarthritis

Question 15

What happens in osteoarthritis?
(2)

Answer 15

The cartilage is affected and wears down

The joint space is narrowed

Question 16

What are the types of arthritis?
(2)

Answer 16

Osteoarthritis

Rheumatoid arthritis

Question 17

What happens in rheumatoid arthritis?

Answer 17

Immune system targets the affected joint

Question 18

How does arthritis look like on a hand x-ray?

Answer 18

Question 19

What are types of chronic conditions seen in the wrist?
(4)

Answer 19

Tennis elbow (injury to lateral epicondyle- soft tissue)

Rickets

Ganglion (fluid filled cists- they sit above the bone)

Carpal tunnel syndrome

Question 20

What is an epicondyle?

Answer 20

Soft tissue

Question 21

What are the standard wrist x-ray views?

Answer 21

PA

Lateral

Question 22

What are the adapted techniques for a wrist x-ray?
(2)

Answer 22

AP

Horizontal beam lateral (HBL)

Question 23

When would AP be used as an adapted technique for a wrist x-ray?

Answer 23

If the patient can’t put their hand on the vertical detector

Question 24

What are common radius and ulna fractures?
(4)

Answer 24

Colle’s fracture

FOOSH injury

Fracture of distal radius with posterior displacement of the distal fragment with dorsal angulation

Dinner fork deformity

Question 25

What does a dinner fork deformity look like?

Answer 25

Question 26

If there’s a mid shaft radius and ulna fracture due to direct impact, what should we do?

Answer 26

Limit patient movement during imaging

Question 27

What do fractures of the radius cause?

Answer 27

The radioulna joint to dislocate

Question 28

What is a galeazzi fracture-dislocation?

Answer 28

A fracture of the mid/distal radius with associate dislocation/subluxation of the distal radioulna joint

Question 29

Who do galeazzi fracture-dislocations tend to occur in?

Answer 29

Children

Question 30

What does a galeazzi fracture-dislocation look like?

Answer 30

Question 31

What is a monteggia fracture-dislocation?

Answer 31

A fracture of the ulna shaft with an associated dislocation of the radial head at the elbow joint

Question 32

What does a monteggia fracture-dislocation look like?

Answer 32

Question 33

What type of fracture is this?

Answer 33

Green stick injury, because the fracture didn’t go all the way through the bone

Question 34

What are the standard x-ray views for the forearm? (2)

Answer 34

AP Lateral

Question 35

What is the adapted technique for a forearm x-ray?

Answer 35

Horizontal beam lateral (HBL)

Question 36

What is the most common carpal bone injury?

Answer 36

Scaphoid fracture

Question 37

What are the features of a scaphoid fracture? (3)

Answer 37

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

Question 38

Label the scaphoid:

Answer 38

Question 39

What should we do when doing scaphoid x-ray views? (2)

Answer 39

Do 4 views at least In UHL 5 views plus external oblique

Question 40

What do scaphoid x-rays taken in UHL look like?

Answer 40

Question 41

What are the most common carpal bone dislocations? (2)

Answer 41

Lunate Perilunate

Question 42

Where do all carpal bones dislocate from when they dislocate?

Answer 42

The lunate

Question 43

What are common elbow injuries? (2)

Answer 43

Supracondylar (fracture above the condyles on the humerus) Transcondylar

Question 44

What does a supracondylar fracture on an elbow look like?

Answer 44

Question 45

What is the most common elbow injury?

Answer 45

Radial head and neck fracture

Question 46

What does a radial head and neck fracture look like?

Answer 46

Question 47

How can we tell if there’s an elbow injury on the x-ray image?

Answer 47

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

Question 49

Why does a posterior sail signs/fat pad mean that there’s an abnormality?

Answer 49

Because it means that fluid in the joint capsule builds and pushes the pericapsular fat away from the humerus