Tag Archives: wrist

Stress Views Hand Wrist
4
Feb

Overview

Stress radiographs apply controlled force to evaluate ligamentous integrity and joint stability in the wrist and hand. They are performed under fluoroscopic guidance or with manual stress during radiography. Stress views help determine need for surgical stabilization.

Technique

Apply varus valgus or axial stress while obtaining targeted projections of the wrist or hand. Use protective measures and informed consent due to discomfort risk. Document the applied stress and technique used for reproducibility.

Clinical Indications

Stress views are indicated for suspected scapholunate instability ulnar collateral ligament injury and carpal instability. They assess dynamic widening or subluxation not evident on static views. MRI may be used to directly visualize ligament tears when needed.

Image Assessment

Measure joint space widening and compare with the contralateral side. Evaluate for dynamic subluxation and associated fractures. Report findings to guide orthopedic decision making and potential surgical repair.

Wrist PA
4
Feb

Overview

The PA wrist radiograph evaluates carpal bones distal radius and ulna for fractures and degenerative change. The patient places the palm flat on the detector with the wrist in neutral. This view is the foundation for wrist imaging and guides further projections.

Technique

Center the detector to the mid carpal region and ensure the wrist is flat without rotation. Use appropriate collimation to include the distal forearm and proximal metacarpals. Immobilize the hand to reduce motion artifact.

Clinical Indications

PA wrist is indicated for trauma pain and suspected scaphoid or distal radius fractures. It assesses carpal alignment and joint space narrowing. Additional oblique and lateral views complement the PA projection.

Image Assessment

Inspect cortical margins for fracture lines and evaluate carpal spacing and alignment. Look for signs of scapholunate dissociation and degenerative changes. Recommend targeted views or CT for occult injuries.

Wrist Lateral
4
Feb

Overview

The lateral wrist radiograph assesses sagittal alignment of the carpus and distal radius. The hand is positioned in true lateral with the thumb side up. This view is important for evaluating dorsal or volar displacement and carpal instability.

Technique

Align the wrist so the radius and ulna are superimposed on the lateral projection. Use consistent positioning and include the distal forearm and metacarpals. Immobilize the hand to minimize motion and ensure reproducibility.

Clinical Indications

Lateral wrist is indicated for trauma suspected dislocation and assessment of carpal alignment. It complements PA and oblique views for comprehensive wrist evaluation. It is useful in preoperative planning and follow up.

Image Assessment

Assess dorsal and volar displacement of fractures and evaluate carpal height and alignment. Look for perilunate and lunate dislocations. Correlate with clinical findings and consider CT for complex injuries.