Wrist

Question 1

Name all carpal bones, starting with proximal row, most lateral

Answer 1

Proximal: Scaphoid/navicular, lunate, triquetrum, pisiform
Distal row: Trapezium, trapezoid, capitate, hamate

Question 2

What is the most commonly fractured carpal bone?

Answer 2

Scaphoid

Question 3

What is the anatomic area located between the 2 major tendons of the thumb? How is this related to wrist imaging?

Answer 3

Snuffbox, it is right where the scaphoid is, indicator of fracture if patient complains of pain there

Question 4

Which carpal bone articulates with the base of the 1st MC?

Answer 4

Trapezium

Question 5

Which carpal bone articulates with the base of the 2nd MC?

Answer 5

Trapezoid

Question 6

Which carpal bone articulates with the base of the 3rd MC?

Answer 6

Capitate

Question 7

Which carpal bone articulates with the base of the 4th & 5th MC?

Answer 7

Hamate

Question 8

Which 2 carpal bones articulate with the distal radius?

Answer 8

Scaphoid, and lunate

Question 9

For PA wrist, how should the fingers be positioned for this image? Why?

Answer 9

Curl fingers under palm, it extends the wrist out and having the fingers extended can close joint spaces, also cause OID

Question 10

For PA wrist, how can you determine that the fingers were not properly positioned?

Answer 10

Joint spaces are closed, distortion of scaphoid bone and foreshortening

Question 11

For PA, what is the CR location?

Answer 11

Mid carpals

Question 12

For PA, how much of the distal radius and ulna should be demonstrated?

Answer 12

2.5” of distal radius and ulna

Question 13

For PA, if properly positioned, which joint/articulation should be demonstrated as open?

Answer 13

Carpal metacarpal joints open

Question 14

For PA, if properly positioned, how should the trapezoid be demonstrated with relation to the trapezium?

Answer 14

Trapezoid partially superimposed over trapezium

Question 15

For PA oblique, what is the position for this image?

Answer 15

Lateral rotation

Question 16

For PA oblique, how much should the part be rotated?

Answer 16

45 degrees

Question 17

For PA oblique, what is the CR location?

Answer 17

Mid carpal

Question 18

For PA oblique, what carpal bone is seen without superimposition when the part is properly positioned?

Answer 18

The trapezoid and trapezium will be seen without superimposition

Question 19

For PA oblique, which parts of the scaphoid/navicular carpal bone will be demonstrated in profile in a properly positioned PA oblique wrist?

Answer 19

The tuberosity waist will be in profile

Question 20

For lateral, what projection is performed?

Answer 20

Lateromedial

Question 21

For lateral, how should the distal radius & ulna be positioned in a lateral wrist?

Answer 21

Radius superimposed over ulna

Question 22

For lateral, what is the CR location?

Answer 22

Wrist joint, where radius meets carpal bones proximal

Question 23

For lateral, how should the metacarpal bases be demonstrated in a properly positioned lateral wrist?

Answer 23

Should be superimposed 2nd-5th

Question 24

For lateral, when evaluating your lateral wrist, you notice that the radius is anterior to the ulna. What error occurred?

Answer 24

Anterior rotation

Question 25

For lateral, when evaluating your lateral wrist, you notice that the ulna is anterior to the radius and the pisiform carpal bone is visible anteriorly. What error occurred?

Answer 25

Posterior rotation

Question 26

For AP oblique, what is the position for this image?

Answer 26

Medial rotation

Question 27

For AP, how much is the part obliqued?

Answer 27

45 degrees

Question 28

For AP, what carpal bone will be best demonstrated in this image? HOW will it be seen?

Answer 28

Medial carpal bones, mainly pisiform, withouth superimposition, in profile with hamate

Question 29

For AP, what is the CR location?

Answer 29

Mid carpals

Question 30

Besides the carpal bone, what other carpal structure will be best demonstrated on this image, AP oblique?

Answer 30

Hamate hook

Question 31

Which way is the hand deviated for PA ulnar deviation?

Answer 31

Towards ulna

Question 32

What will be best demonstrated in a PA ulnar deviation?

Answer 32

Scaphoid, opens joint spaces between adjacent carpals

Question 33

CR location for PA ulnar deviation?

Answer 33

Scaphoid

Question 34

For PA radial deviation, which way is the hand deviated?

Answer 34

Towards radius

Question 35

For PA radial deviation, what will be best demonstrated?

Answer 35

Open interspaces between carpals on the medial side of wrist, scaphoid

Question 36

For PA axial projection, what 2 ways can this projection be performed? Describe each.

Answer 36

Fingers fully extended, tube angled at 20 degrees towards the elbow, or angle part at 20 degrees

Question 37

For PA axial, what is the method name?

Answer 37

Stetcher method

Question 38

For PA axial, what is the CR/ part angle?

Answer 38

20 degrees

Question 39

For PA axial, what is the CR location?

Answer 39

Scaphoid

Question 40

For PA axial, which carpal bone is best demonstrated? How should the bone be seen?

Answer 40

Scaphoid, without superimposition

Question 41

What does tangenital mean?

Answer 41

Diverging, hardly touching

Question 42

What is the method name for tangential wrist?

Answer 42

Gaynor hart method

Question 43

What is best demonstrated in this image for tangential wrist?

Answer 43

Carpal canal, pisiform without superimposition, hamate hook

Question 44

How is the hand/wrist positioned for this image for tangential wrist?

Answer 44

Hand is perpendicular to IR

Question 45

What is the CR location for tangential wrist?

Answer 45

1” distal to base of 3rd metacarpal, middle of palm

Question 46

What is the CR angle/direction for tangential wrist?

Answer 46

25-30 degrees to long axis of hand

Question 47

Which carpal bones are of interest for tangential?

Answer 47

pisiform without superimposition, hamate hook, and trapezium