Matthew R. Minor MD, Presenter: Nothing to Disclose

Liem Thanh Mansfield MD, Abstract Co-Author: Nothing to Disclose

Bradley John Carra MD, Abstract Co-Author: Nothing to Disclose

Systematic checklist approach to the evaluation of wrist radiographs ensures detection of common and uncommon diagnoses. Evaluation of the carpal arcs helps to detect subtle cases of carpal dislocations. Understanding the concept of carpal arcs of injuries enables the radiologist to detect the combination of injuries that is common in wrist trauma.

1. Common radiographic views 2. Osseous anatomy 3. Checklist a. White cortical line outlining all bones b. PA view   1. Joints: radiocarpal, distal radioulnar, and carpometacarpal   2. Carpal arcs are smooth and concave   3. Contour of ulna parallels contour of radius   4. Cortical rim of hook of hamate   5. Ulnar variance: positive, negative c. Lateral view   1. Metacarpals alignment   2. Capitate, lunate and radius align   3. Contour of ulna parallels contour of radius d. Soft tissue assessment   1. Fat stripes: scaphoid, pronator quadratus   2. Mass 4. Concept of carpal arcs of injuries 5. Cases a. Carpal coalitions b. Ulnar variance c. Fractures d. Dislocations   1. Carpal: RSS, DISI, VISI, perilunate, midcarpal, lunate   2. Carpometacarpal joint   3. Distal radioulnar joint e. Soft tissue   1. Abnormal fat stripe   2. Ganglionic cyst   3. Tenosynovitis   4. Neoplasms  

http://abstract.rsna.org/uploads/2014/14011989/14011989_rm31.pdf

Minor, M, Mansfield, L, Carra, B, Flick of the Wrist and You Are Done: Systematic Approach to the Radiographic Interpretation of the Wrist to Avoid Common Diagnostic Errors.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011989.html