Wrist Hand

PA, arcuate lines, subluxation, ulnar, radial deviation

standard radiologic projection is _____, 3 _____ are noted, differences can be indicative of _____, can be performed with _____/_____ bias

ulnar, superimposed, thumb, displacement

lateral viewing has _____ side on image receptor, phalanges/metacarpals are _____, places _____ in PA position, used to determine amount of _____ with deformity/fracture

down, supinated, phalanges, superimposition

oblique has palm _____ with thumb rotated in _____ direction, utilized when _____ are of interest = without _____

carpal tunnel, pronated, tunnel, compressing, median nerve, flexor tendons

_____ view = tangential inferior to superior view of wrist with forearm _____ and flat on table, demonstrates carpals in _____ like projection to identify abnormalities that are _____ the ____/_____

hook of hamate fractures

carpal tunnel view used for _____

ulnar, radial deviation, clenched fist, instability, cineradiography

dynamic/stress views = PA with _____/_____ or _____, imaging for wrist _____, can use _____

articular, osteochondral, comminuted fractures

CT is more beneficial for _____, _____, and _____ + complex/subtle fractures

bone marrow edema, joint instability, soft tissue, scapholunate ligament tear, TFCC

MRI is beneficial in noting _____, carpal/distal radioulnar _____ and _____ injuries, arthrography can be added for _____ and _____ region

age, swelling, deformity, distal radius, palmar flexion, supination, ulnar deviation, radioulnar ballotment

amsterdam wrist rule = distal radial fracture with increased _____, wrist _____, visible _____, _____ tenderness, pain with ____/_____/_____, painful _____ test

24 hours, pain, wrist extension, radial deviation, distal ulna, radioulnar drawer, axial compression

karadeniz wrist rules = within ____ of acute trauma have ____ with active ____/_____, palpation of _____, _____ test and _____

sensitivity, unneeded

fracture rules have high _____ to reduce _____ radiographs

distal radius, post menopausal women, FOOSH

fracture of _____ is most common in children, or in _____, MOI = _____

distal radius, dorsal angulation

colles fracture = fracture of _____ with _____ (dinner fork deformity)

reverse, dorsal distal radius, volar angulation

smith fracture = _____ colles fracture with _____ fracture and _____ of segment

distal radius, distal radioulnar dislocation

galeazzi fracture = fracture of _____ with _____

PA and lateral radiographs, ligamentous, MRI/CT arthrography

distal radius fracture imaging = _____ but _____ injuries are common and require _____

ulnar styloid, displaced, TFCC, fixation

_____ fractures occur commonly with distal radial fractures and are often _____ and associated with _____ injuries, _____ typically required to restore positioning and stability

radiographs, immobilize, reevaluate, radiodensity, edema, healing

if hand fractures are suspected ______ are ordered and if NEGATIVE = _____ and _____ in 10-14 days given likelihood of _____ changes (reduced _____) and fracture _____

5th metacarpal, 1st metacarpal

boxer’s fracture = _____ vs bennet fracture = _____

FOOSH, dorsiflexion, inversion, intercarpal supination

most carpal injuries are due to _____ with hand in forced _____/_____/_____

proximal, poor, AVN, waist, distal, improved

scaphoid fracture can occur in _____ pole (= _____ blood supply and high _____ risk), _____, or _____ pole (_____ blood supply)

anatomic snuff box, scaphoid tubercle, scaphoid shift, watson, longitudinal compression

scaphoid fracture clinical signs are _____ and _____ tenderness, _____ and _____ test, thumb _____

male, swelling, palpation, ulnar deviation, thumb compression

amsterdam scaphoid rule = _____ gender, anatomical snuff box _____ and painful _____, painful _____ and _____

PA with ulnar deviation radiograph, reimage, immobilization, negative

scaphoid fracture imaging = _____ and _____ after 2 weeks _____, MRI/CT ordered with _____ radiographs (or bone scan)

fall, hyperextended, forceful push, AVN

lunate fracture MOI = _____ on _____ wrist or _____ in that position, often ignored until radiographic evidence of _____ (keinbock’s deformity)

gradual increase, swelling, stiffness, grip strength

lunate fracture signs = _____ in pain, _____, wrist _____, and decreased _____

radiographs, AVN

lunate fracture imaging = _____ initially with advanced imaging with negative and high suspicion especially with _____

direct blow, 5th metacarpal, strike, ulnar nerve

hamate fracture MOI = _____ through _____ (fist strike) or sports with exposure and _____, fracture and dislocation of concern due to close proximity to the _____

carpal tunnel, PA with radial deviation radiograph

hamate fracture imaging = _____ and _____

history, exam, loaded

wrist instability diagnosis based on _____ and _____, standard imaging initially + _____ imaging can be performed

stabilizer, distal radioulnar joint, rotation, sliding, force transmission

TFCC serves as important _____ of _____ controlling _____ and _____ movements, accepts some _____

direct blow, excessive loading, ulnar, radius, dislocation, loading

TFCC lesion MOI = _____ and _____ through _____ side of hand or with injuries to ____ and _____ causing change in mechanics to increase _____ on TFCC tissue

ulnar, ulnar deviation, loading, gripping

TFCC lesion presents with pain on _____ side of wrist, worse with _____ and _____/_____ especially in full pronation, use ulnomeiscaltriquetral dorsal glide and GRIT testing

MRI, arthrography

TFCC lesion imaging = _____/_____

compressive neuropathy, median nerve, compression, inflammatory, mechanical, fluid, median nerve, flexor tendons

carpal tunnel syndrome is _____ of _____ at wrist, caused by anatomic _____, _____ conditions, _____ forces, _____ dynamic changes (pregnancy), carpal tunnel contains _____ and 9 _____

paresthesia, night, gripping, loading, wasting

carpal tunnel presents with pain and _____ in median nerve distribution, worse at _____ and with _____/_____, testing is tinel’s, phalen’s, monofilament, thenar eminence _____

>45, ratio, symptom severity, thumb sensation, flick

wainner’s cluster for carpal tunnel = age _____, wrist ____ >0.67, CTS _____ score >1.9, diminished _____, positive _____ test

EMG, NVC, carpal tunnel radiograph, osseous, ultrasound, median nerve

carpal tunnel imaging = _____/_____ for nerve function, exam for diagnosis, _____ for _____ defect, _____ for superficial structures and status around _____

small, IP, 1st CMC, 50, joint space, sclerosis, osteophyte, deformity

DJD (OA) is seen in _____ (_____ and _____) joints of hand after _____ age, radiologic findings are decreased _____, subchondral _____, _____ formation at joint margin, and joint _____ (distal = Heberden’s vs proximal = Bouchard’s)

systemic, bilateral, MCP, IP, radiolucency, angulation deformity

RA is _____ condition = _____ presentation, seen in small joints (_____ and proximal _____), see increased _____ and _____