Radiographic evaluation of wrist trauma

Abstract

T HE EVALUATION of wrist trauma is an with the distal ulna forming the inferior or distal important clinical problem and radioradioulnar joint. graphic studies play a key role. The wrist is subject to a high level of use and abuse, both in the activities of daily living and in athletic endeavors. Analysis of wrist radiographs following trauma requires a thorough understanding of carpal anatomy, dynamics, and pathomechanits, so that subtle abnormalities are not overlooked and prompt and appropriate therapy can be instituted. This study reviews the complex anatomy of the wrist and concentrates on plain radiographic evaluation of the injured wrist; the use of other imaging modalities such as radionuelide bone scanning, conventional and computed tomography (CT), fluoroscopy, arthrography, and magnetic resonance imaging (MRI) in the evaluation of the traumatized wrist will also be addressed. The eight carpal bones are arranged in two concentric rows: the proximal row contains the scaphoid (navicular), lunate, triquetrum, and the pisiform, a sesamoid in the tendon of the flexor car-pi ulnaris that articulates with the triquetrum; the distal row is composed of the trapezium (greater multangular), trapezoid (lesser multangular), capitate, and hamate. Termed an “intercalated segment,“’ the proximal row is interposed dynamically between the radius and the distal carpal row. The scaphoid actually bridges the proximal and distal rows, rendering stability.‘13