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RADT308-HAND & WRIST
Review of radiographic anatomy, positioning and pathology
| Question | Answer |
|---|---|
| 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 |
| inflammation of the bursae or fluid-filled sacs that enclose the joints; involves the formation of calcification in associated tendons | bursitis |
| 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 |
| break in the structure of bone caused by force | fracture |
| fracture of the base of the first metacarpal bone extending into the CMC joint complicated by subluxation with some posterior displacement | bennet's fracture |
| transverse fracture that extends through the metacarpal neck most commonly seen in the fifth metacarpal | boxer's fracture |
| accumulated fluid in the joint cavity; sign of an underlying condition | joint effusion |
| aka DJD; noninflammatory joint disease charachterized by gradual deterioration of the articular cartilagewith overgrown bone formation; most common type of arthritis | osteoarthritis |
| local or gernalized infection of bone or bone marrow | osteomyelitis |
| hereditary disease marked by abnormally dense bone; also known as marble bone | osteopetrosis |
| reduction in the quantity of bone or atrophy of skeletal tissue; common in postmenopausal women and elderly men | osteoporosis |
| 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 |
| 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 |
| sprain or tear of the ulnar collateral ligament of the thumb near the MCP joint of the hyperextended thumb | skier's thumb |
| 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 |
| second most common type of primary cancerous bone tumor; affects ages 10-20 primarily | osteogenic sarcoma |
| 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 |
| slow-growing malignant tumor of the cartilage | chondrosarcoma |
| slow-grwoing benign cartilaginous tumor | endochondroma |
| most common type of benign bone tumor | osteochondroma |
| SID for hand positioning | 40 |
| phalanges should lie _______ to IR | parallel |
| number of carpals in the hand and wrist | 8 |
| number of metacarpals in the hand and wrist | 5 |
| number of phalanx in the hand and wrist | 14 |
| joint between the phalanges and metacarpals | MCP |
| joint between the proximal and middle phalanx | PIP |
| joint between the middle and distal phalanx | DIP |
| joint between the proximal and distal phalanx of 1st digit | IP |
| joint between the metacarpal and carpals | CMC |
| thumb articulates with this carpal | trapezium |
| 5th metacarpal articulates with this carpal | hamate |
| IP joint movement type | ginglymus |
| ginglymus is also known as this | hinge type |
| all joints in the hand and wrist are classified as | synovial |
| MCP joints movement type | ellipsoidal |
| number of directions of movement for an ellipsoidal joint | four - flex, ext, abd, add |
| 1st MCP joint may also have what additional movement besides those of the ellipsoidal joint | circumduction |
| CMC joints (2nd-5th) joint movement | plane |
| CMC joint (1st) joint movement | sellar |
| what rule states that you must have at least 30% of the IR covered for digital images? | 30% rule |
| why does 30% of the IR need to be covered in digital imaging? | for accurate EI reading |
| if doing more than one view per IR, what precautions should you take | lead masking, collimation |
| true/false: you need a grid for hand imaging | false |
| displacement from the joint | dislocation |
| partial dislocation from the joint | subluxation |
| rupture or tearing of connective tissues | sprain |
| bruise without fracture | contusion |
| type of fracture where fragments are driven into each other | impacted |
| type of fracture where there is a splintering or crushed fracture fragments | comminuted |
| a fracture that breaks through the skin | compound |
| 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 |
| centering point for PA hand | third MCP |
| hand is in the position for the PA view | prone |
| exposure factor for PA hand | 55-65 kV |
| centering point for PA oblique | third MCP |
| degree of obliquity for PA oblique | 45 |
| if fourth and fifth metacarpals are superimposed on the PA oblique radiograph, what happened? | rotated more than 45 degrees |
| exposure factors for PA oblique | 55-65 kV |
| what happens if you do not maintain parallel fingers on the oblique view? | foreshortening of phalanges and obscuration of IP joints |
| centering point for fan lateral hand | second MCP |
| why do a fan lateral compared to a normal lateral? | demonstrates phalanges better |
| exposure factors for fan lateral | 55-65 kV |
| what position of the hand places the thumb in a PA position | lateral |
| why should a lateral hand be done in a hand series? | metacarpal alignment and FB localization (extension lateral) |
| if patient presents with FB, what type of lateral would you perform? | extension lateral |
| what position has the 2nd-5th metacarpals superimposed with the 1st digit lightly touching the 2nd digit? | flexion lateral |
| where is the centering point for an extension lateral | 2nd MCP |
| where is the centering point for a flexion lateral | 2nd MCP |
| what exposure factors are used for extension/flexion laterals? | 55-65 kV |
| what degree oblique is used for the norgaard method? | 45 |
| norgaard is also known as the ____ position | ball-catchers |
| centering point for the norgaard method | level of the fifth MCP joints |
| exposure factors for norgaard method | 55-65 kV |
| why perform the norgaard method? | early detection of RA |
| fracture and dislocation of the posterior lip of the distal radius involving the wrist joint | Barton's fracture |
| 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 |
| reverse of colles' fracture, or transverse fracture of the distal radius with distal fragment displaced anteriorly | smith's fracture |
| where is the centering point for a PA wrist | midcarpal |
| where is the centering point for a PA oblique wrist | midcarpal |
| where is the centering point for a Lateral wrist | midcarpal |
| where is the centering point for a pa radial deviation | midcarpal area |
| where is the centering point for a pa ulnar deviation | scaphoid (3/4" distal and medial to radial styloid) |
| where is the centering point for a pa scaphoid modified stetcher | scaphoid (3/4" distal and medial to radial styloid) |
| where is the centering point for a carpal canal? | 1" distal to base of 3rd metacarpal |
| where is the centering point for a carpal bridge | 1.5" proximal to wrist joint |
| kv for digital system for a PA wrist | 55-65 |
| kv for digital system for a PA oblique | 60-70 |
| kv for digital system for a lateral wrist | 60-70 |
| kv for digital system for a pa scaphoid | 55-65 |
| kv for digital system for a radial deviation | 55-65 |
| kv for digital system for a carpal canal | 55-65 |
| kv for digital system for a carpal bridge | 55-65 |
| another name for a carpal canal view | tangential inferosuperior or gaynor-hart method |
| what is the CR angle for the carpal bridge? | 45 degrees to long axis of forearm |
| what is the CR angle for the carpal canal? | 25-30 degrees to the long axis of the hand |
| what is the flexion of wrist for the carpal bridge | 90 |
| what is the extension of the hand for the carpal canal | 90 |
| how much is the hand elevated for a modified stetcher | 20 degrees |
| why do the modified stetcher vs. pa axial scaphoid? | places scaphoid parallel to IR |
| why do ulnar deviation for scaphoid? | decreases superimposition of scaphoid with adjacent carpal bones |
| what alternative can you do for a modified stetcher if you do not have a 20 degree wedge? | Have patient clench their fist |
| what degree of obliquity is necessary for PA oblique wrist | 45 degrees |
| 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. |
| why arch hand for a PA wrist? | places wrist joint and carpals in close contact with IR |
| position that opens the lateral side of the carpal bones? | ulnar deviation |
| position that opens the medial side of the carpal bones | radial deviation |
| position that is ideal for demonstrating calcification in the dorsal aspect of the carpals? | carpal bridge |
| position that is ideal for demonstrating the carpal sulcus? | carpal canal, Gaynor Hart method |
| position that will demonstrate the pisiform and hamate the best? | carpal canal, Gaynor Hart method |
| carpals that articulate with the radius? | scaphoid, lunate |
| smallest of the carpal bones | pisiform |
| largest of the carpal bones | capitate |
| proximal row of carpals | scaphoid lunate triquetrum pisiform |
| distal row of carpals | trapezium, trapezoid, capitate, hamate |
| type of movement for the radiocarpal joint | ellipsoidal |
| cast conversion for small to medium dry plaster cast | +5-7kV |
| cast conversion for large or wet plaster cast | +8-10 kV |
| cast conversion for fiberglass cast | +3-4 kV |
| ulnar deviation means to move the hand toward which bone? | ulna |
| radial deviation means to move the hand toward which bone | radius |
Created by:
hschmuck1
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