Review of radiographic anatomy, positioning and pathology
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| transfer of disease or cancerous lesions from one organ or part that may not be directly connected. Most common of malignant bone tumors | bone metastases
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| inflammation of the bursae or fluid-filled sacs that enclose the joints; involves the formation of calcification in associated tendons | bursitis
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| common painful disorder of the wrist and hand that results from compression of the median nerve as it passes through the center fo the wrist | carpal tunnel syndrome
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| break in the structure of bone caused by force | fracture
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| fracture of the base of the first metacarpal bone extending into the CMC joint complicated by subluxation with some posterior displacement | bennet's fracture
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| transverse fracture that extends through the metacarpal neck most commonly seen in the fifth metacarpal | boxer's fracture
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| accumulated fluid in the joint cavity; sign of an underlying condition | joint effusion
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| aka DJD; noninflammatory joint disease charachterized by gradual deterioration of the articular cartilagewith overgrown bone formation; most common type of arthritis | osteoarthritis
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| local or gernalized infection of bone or bone marrow | osteomyelitis
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| hereditary disease marked by abnormally dense bone; also known as marble bone | osteopetrosis
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| reduction in the quantity of bone or atrophy of skeletal tissue; common in postmenopausal women and elderly men | osteoporosis
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| chronic skeletal diseases; destructive bone disease followed by a reparitive process of overproduction of very dense yet soft bones that tend to fracture easily; most common in men older than 40 | paget's disease
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| chronic systemic disease with inflammatory changes throughout the body's connective tissues; early bone erosions typically occur first at the 2nd and 3rd MCP joints or the 3rd proximal interphalangeal joint; 3 times more common in women than men | rheumatoid arthritis
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| sprain or tear of the ulnar collateral ligament of the thumb near the MCP joint of the hyperextended thumb | skier's thumb
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| most comon of the primary cancerous bone tumors; generally affects persons between the ages of 40 and 70; arise from bone marrow or marrow plasma cells; radiographic appearance of punched out osteolytic lesions scattered throughout the affected bones | multiple myeloma
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| second most common type of primary cancerous bone tumor; affects ages 10-20 primarily | osteogenic sarcoma
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| common primary malignant bone tumor in children and young adults; arises from bone marrow; symptoms similar to osteomyelitis with low-grade fever and pain; onion peel appearance on radiographs | ewing's sarcoma
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| slow-growing malignant tumor of the cartilage | chondrosarcoma
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| slow-grwoing benign cartilaginous tumor | endochondroma
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| most common type of benign bone tumor | osteochondroma
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| SID for hand positioning | 40
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| phalanges should lie _______ to IR | parallel
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| number of carpals in the hand and wrist | 8
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| number of metacarpals in the hand and wrist | 5
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| number of phalanx in the hand and wrist | 14
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| joint between the phalanges and metacarpals | MCP
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| joint between the proximal and middle phalanx | PIP
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| joint between the middle and distal phalanx | DIP
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| joint between the proximal and distal phalanx of 1st digit | IP
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| joint between the metacarpal and carpals | CMC
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| thumb articulates with this carpal | trapezium
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| 5th metacarpal articulates with this carpal | hamate
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| IP joint movement type | ginglymus
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| ginglymus is also known as this | hinge type
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| all joints in the hand and wrist are classified as | synovial
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| MCP joints movement type | ellipsoidal
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| number of directions of movement for an ellipsoidal joint | four - flex, ext, abd, add
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| 1st MCP joint may also have what additional movement besides those of the ellipsoidal joint | circumduction
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| CMC joints (2nd-5th) joint movement | plane
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| CMC joint (1st) joint movement | sellar
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| what rule states that you must have at least 30% of the IR covered for digital images? | 30% rule
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| why does 30% of the IR need to be covered in digital imaging? | for accurate EI reading
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| if doing more than one view per IR, what precautions should you take | lead masking, collimation
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| true/false: you need a grid for hand imaging | false
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| displacement from the joint | dislocation
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| partial dislocation from the joint | subluxation
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| rupture or tearing of connective tissues | sprain
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| bruise without fracture | contusion
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| type of fracture where fragments are driven into each other | impacted
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| type of fracture where there is a splintering or crushed fracture fragments | comminuted
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| a fracture that breaks through the skin | compound
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| type of fracture that happens when a finger is extended and is jammed resulting in an avulsion fx occurring at the posterior base of the distal phalanx | baseball or mallet fracture
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| centering point for PA hand | third MCP
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| hand is in the position for the PA view | prone
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| exposure factor for PA hand | 55-65 kV
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| centering point for PA oblique | third MCP
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| degree of obliquity for PA oblique | 45
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| if fourth and fifth metacarpals are superimposed on the PA oblique radiograph, what happened? | rotated more than 45 degrees
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| exposure factors for PA oblique | 55-65 kV
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| what happens if you do not maintain parallel fingers on the oblique view? | foreshortening of phalanges and obscuration of IP joints
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| centering point for fan lateral hand | second MCP
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| why do a fan lateral compared to a normal lateral? | demonstrates phalanges better
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| exposure factors for fan lateral | 55-65 kV
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| what position of the hand places the thumb in a PA position | lateral
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| why should a lateral hand be done in a hand series? | metacarpal alignment and FB localization (extension lateral)
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| if patient presents with FB, what type of lateral would you perform? | extension lateral
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| what position has the 2nd-5th metacarpals superimposed with the 1st digit lightly touching the 2nd digit? | flexion lateral
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| where is the centering point for an extension lateral | 2nd MCP
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| where is the centering point for a flexion lateral | 2nd MCP
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| what exposure factors are used for extension/flexion laterals? | 55-65 kV
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| what degree oblique is used for the norgaard method? | 45
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| norgaard is also known as the ____ position | ball-catchers
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| centering point for the norgaard method | level of the fifth MCP joints
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| exposure factors for norgaard method | 55-65 kV
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| why perform the norgaard method? | early detection of RA
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| fracture and dislocation of the posterior lip of the distal radius involving the wrist joint | Barton's fracture
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| transverse fracture of the distal radius in which the distal fragment is displaced poseteriorly; an associated ulnar styloid fracture seen in 50-60% of cases | Colles' fracture
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| reverse of colles' fracture, or transverse fracture of the distal radius with distal fragment displaced anteriorly | smith's fracture
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| where is the centering point for a PA wrist | midcarpal
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| where is the centering point for a PA oblique wrist | midcarpal
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| where is the centering point for a Lateral wrist | midcarpal
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| where is the centering point for a pa radial deviation | midcarpal area
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| where is the centering point for a pa ulnar deviation | scaphoid (3/4" distal and medial to radial styloid)
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| where is the centering point for a pa scaphoid modified stetcher | scaphoid (3/4" distal and medial to radial styloid)
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| where is the centering point for a carpal canal? | 1" distal to base of 3rd metacarpal
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| where is the centering point for a carpal bridge | 1.5" proximal to wrist joint
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| kv for digital system for a PA wrist | 55-65
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| kv for digital system for a PA oblique | 60-70
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| kv for digital system for a lateral wrist | 60-70
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| kv for digital system for a pa scaphoid | 55-65
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| kv for digital system for a radial deviation | 55-65
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| kv for digital system for a carpal canal | 55-65
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| kv for digital system for a carpal bridge | 55-65
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| another name for a carpal canal view | tangential inferosuperior or gaynor-hart method
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| what is the CR angle for the carpal bridge? | 45 degrees to long axis of forearm
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| what is the CR angle for the carpal canal? | 25-30 degrees to the long axis of the hand
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| what is the flexion of wrist for the carpal bridge | 90
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| what is the extension of the hand for the carpal canal | 90
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| how much is the hand elevated for a modified stetcher | 20 degrees
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| why do the modified stetcher vs. pa axial scaphoid? | places scaphoid parallel to IR
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| why do ulnar deviation for scaphoid? | decreases superimposition of scaphoid with adjacent carpal bones
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| what alternative can you do for a modified stetcher if you do not have a 20 degree wedge? | Have patient clench their fist
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| what degree of obliquity is necessary for PA oblique wrist | 45 degrees
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| what benefit does an AP wrist have over a PA wrist? | places wrist and carpals in close contact with IR demonstrating intercarpal spaces more parallel to the divergent rays.
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| why arch hand for a PA wrist? | places wrist joint and carpals in close contact with IR
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| position that opens the lateral side of the carpal bones? | ulnar deviation
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| position that opens the medial side of the carpal bones | radial deviation
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| position that is ideal for demonstrating calcification in the dorsal aspect of the carpals? | carpal bridge
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| position that is ideal for demonstrating the carpal sulcus? | carpal canal, Gaynor Hart method
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| position that will demonstrate the pisiform and hamate the best? | carpal canal, Gaynor Hart method
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| carpals that articulate with the radius? | scaphoid, lunate
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| smallest of the carpal bones | pisiform
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| largest of the carpal bones | capitate
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| proximal row of carpals | scaphoid lunate triquetrum pisiform
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| distal row of carpals | trapezium, trapezoid, capitate, hamate
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| type of movement for the radiocarpal joint | ellipsoidal
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| cast conversion for small to medium dry plaster cast | +5-7kV
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| cast conversion for large or wet plaster cast | +8-10 kV
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| cast conversion for fiberglass cast | +3-4 kV
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| ulnar deviation means to move the hand toward which bone? | ulna
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| radial deviation means to move the hand toward which bone | radius
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