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Radiology of the Hand and Wrist


- Findings:
     - Carpal height & Carpal height ratio 
     - Distal Radius Fracture
     - Radial Length & Width 
     - Scapholunate Dislocation
     - Scaphoid Fracture

- Types of Radiographs:
     - Arthrography of the Wrist
     - AP View
     - Carpal Tunnel View
     - Clenched Fist PA
     - Lateral View
     - PA View
     - Pronated Olblique - demonstrates adequately STT joint;
     - Reverse Oblique - 15 deg
     - Supinated Oblique
     - Ulnar Variance
     - Zero Rotation Views


- AP View is prefered for Wrist Pathology:
     - AP has dorsum of hand touching film, w/ x-ray beam passing palmar to dorsal, whereas in PA film, palmar surface lies flat on film & x-ray beam passes from the dorsal to palmar surface;
     - palmar surfaces of most carpal bones are narrower, & these bones are best profiled in AP projection because of the alignment of the peri-articular cortices with the diverging incident x-ray beam;
     - position of ulnar styloid will determine which way film was obtained;
            - in standard PA view, ulnar styloid is peripheral;
            - in standard AP View, ulnar styloid points centrally



Problem Disorders of the Wrist--Symposium: The Vascularity of the Wrist: Identification of *Arterial* Patterns at Risk.

An alternative method for determination of the carpal height ratio.

Roentgenographic examination of the wrist: a systematic study of the normal, lax and injured wrist. Part 1: The standard and positional views.

Roentgenographic examination of the wrist: a systematic study of the normal, lax and injured wrist. Part 2: Stress views.



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