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Fingers Hand & Wrist
Position
Question | Answer |
---|---|
Distal Carpals | Trapezium, Trapezoid, Capitate, Hamate |
Proximal Carpals | Pisiform, Triquetrum, Lunate, Scaphoid/Navicular |
Anatomical Snuff Box | Overlies the Scaphoid bone **Most frequently fractured carpal bone |
AP Thumb | Position:Supinated Projection:Ap CR:MCP Joint **Must include the Trapezium |
PA Oblique Thumb | Position:Hand pronated, Thumb abduct Projection:Pa Oblique CR:MCP Joint |
Lateral Thumb | Position:Lateral Projection:Mediolateral CR:MCP Joint |
PA Fingers 2-5 | Position:Prone Projection:PA CR:PIP Joint |
PA Oblique Fingers 2-5 | Position:External Rotation Projection:PA Oblique CR:PIP Joint |
Lateral Fingers 2-5 | Position:Lateral Projection:Mediolateral (2-3), Lateromedial (4-5) CR:PIP Joint |
PA Fingers 2-5 Images | *Concavity of phalangeal shafts *Equal amount of soft tissue on both sides *Fingernail is centered over distal phalanx |
Lateral Fingers 2-5 Images | *Concave anterior aspect of the phalangeal shaft *Open joints *No overlap of the other digits *Anatomy: head, body, & base |
Why keep digits parallel to film? | 1.Keep joint spaces open 2.Prevent foreshortening |
PA Hand | Position:Prone Projection:PA CR:3rd MCP Joint |
PA Oblique Hand | Position:External Rotation Projection:PA Oblique CR:3rd MCP Joint |
Fan Lateral Hand | Position:Fan Lateral Projection:Lateromedial CR:2nd MCP Joint |
Fan Lateral Image | Superimposed metacarpals *See individual phalanges without superimposition |
Lateral in Extension | Position:Lateral in Extension Projection:Lateromedial CR:2nd MCP Joint |
Lateral in Extension Image | Superimposed digits, metacarpals, distal forearm *Thumb abducted |
Why use a lateral in extension? | 1.To localized foreign body 2.Show soft tissue 3.Show metacarpal fx displacements |
PA Wrist | Position:Prone Projection:Pa CR:Midcarpals |
PA Oblique Wrist | Position:Lateral Rotation from prone Projection:PA Oblique CR:Midcarpals |
Lateral Wrist | Position:Lateral Projection:Lateromedial CR:Wrist Joint |
AP Oblique Wrist | Position:Medial Rotation from supine Projection:AP Oblique CR:Midcarpals |
Why do a PA Oblique vs. AP Oblique Wrist? | PA Oblique demo scaphoid & trapezoid *carpals on lateral aspect AP Oblique shows the pisiform free from superimposition |
Ulnar Deviation Wrist | Position:Prone with Ulnar deviation Projection:Pa CR:Scaphoid |
Radial Deviation Wrist | Position:Prone with Radial deviation Projection:Pa CR:Midcarpals |
Ulnar Deviation vs Radial Deviation | Ulnar Deviation: carpals on lateral aspect *shows scaphoid with no foreshortening & adjacent joints open Radial Deviation: carpals on medial aspect *Shows the pisiform |
Stecher Method | Position:Stecher Method Projection:PA Axial CR:Perpendicular or angled 20 degrees toward elbow & enters scaphoid |
Why the Stecher Method? | shows the scaphoid without foreshortening |
Gaynor Hart Method | Position:Gaynor Hart Method Projection:Tangential CR:25-30 degrees to long axis of hand, 1" distal to base of 3rd MC |