Basic Radiograph ROUTINE PA Lateral Scaphoid series when there is tenderness in the anatomical snuff box PA ulnar deviation note the disruption of arc I at the lunotriquetral joint ID: 935885
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Slide1
Imaging of Wrist
DR AMITA HARSULE
Slide2Basic Radiograph
ROUTINE
■ PA
■ Lateral
■ Scaphoid series – when there is tenderness in the anatomical snuff box.
Slide3Slide4PA ulnar deviation
Slide5Slide6Slide7Slide8Slide9Slide10Slide11Slide12Slide13note the disruption of arc I at the lunotriquetral joint.
Slide14A disruption of the second carpal arc at the scapholunate joint and the lunotriquetral joint is seen on the left.
Slide15There is an abnormal step off at the
capitohamate
joint.
Slide16Slide17Slide18Volar aspect of the wrist
Slide19USG
Slide20Slide21CT
Slide22CT
Slide23Slide24Slide25Ligamentous Anatomy
Classified as either extrinsic or intrinsic.
The extrinsic ligaments link the carpal bones to the radius and ulna.
The intrinsic or intercarpal ligaments connect the individual carpal bones
.
Slide26Slide27Normal TFCC.
Triangular fibrocartilage proper (*).
Foveal (arrow) and styloid (dashed arrow) insertions.
Meniscus homologue (arrow head).
Normal lunotriquetral (LTL) and scapholunate (SLL) ligaments are also seen.
Slide28MENISCUS HOMOLOGUE
Slide29Slide30Slide31Slide32Slide33Slide34Tendon pathology
Tendon pathology is often encountered in the wrist and hand,
which may be the result of overuse, trauma or inflammation.
Patients typically present with focal pain and swelling. The term "tendinitis" is an inaccurate term A better term is tendinosis, which describes a degenerative process with "microtears", healing and vascular in-growth. The term "tendinopathy" encompasses both degenerative and inflammatory conditions. Tenosynovitis refers to inflammatory change within the tendon sheath, with or without tendon morphological changes.
Slide35flexor tenosynovitis
Slide36Slide37Slide38Slide39Slide40Carpal Tunnel $
Causes include flexor tenosynovitis, trauma, systemic inflammatory disease, pregnancy,
acromegaby
, hypothyroidism
Slide41Space-occupying lesions within the carpal tunnel such as ganglia, tenosynovitis, and anatomic variants are well seen with MR imaging
MR imaging is therefore indicated only in patients with equivocal clinical findings, a suspected mass
Slide42Slide43Slide44Slide45Slide46Slide47Compressive ulnar neuropathy.
At the level of the canal of
Guyon’s
.
The Guyon canal is a triangular space lateral to the pisiform bone and medial to the hamate that contains the ulnar nerve and ulnar artery. The ulnar nerve (arrow) has high signal intensity and it is thickened. There is a ganglion cyst (*) compressing the ulnar nerve against the pisiform.
Slide48GANGUON CYSTS
Seventy percent of all wrist ganglia occur dorsally adjacent to the SLL
Slide491. ganglion cyst that arises from the dorsal aspect of the SLL
2. volar ganglion cyst adjacent to the
radioscaphoid
joint
Slide50schwannoma
of radial nerve
Slide51THANK YOU