WRIST RADIOGRAPHY , Bathmahariswaran (1).pptx

WRIST RADIOGRAPHY , Bathmahariswaran (1).pptx

1. WRIST RADIOGRAPHY By Bathmahariswaran. U. G Bsc RIT II year NAHS MR. Dinesh sekar msc Radiology Asst professor/clinical supervisor Department of Radiology

2. ANATOMY OF WRIST Carpal bones Capitate Pisiform Scaphoid bone Hamate Lunate bone Trapezoid Trapezium Triquetral bone

3. metacarpal Metacarpal bones metacarpal metacarpal metacarpal metacarpal 1 2 3 4 5

4. •Scaphoid - Postero-anterior- ulnar deviation •CARPAL TUNNEL - Axial •Postero-anterior •Lateral -method 1 •Oblique (anterior oblique) WRIST (Posterior oblique)

5. Position of the Patient Scaphoid - Postero-anterior - ulnar deviation The patient is placed in a sitting position. Pronate the hand on the image receptor (IR). Place the hand tightly on IR and flex the wrist to ulnar side. Place wrist joint at the center of IR. Adjust the posture to align wrist joint and elbow joint in a straight line.

6. kVp 18 × 24 cm (8 × 10 inch) =53 mAs = 4 Central Ray perpendicular beam directed at the wrist joint IR Size and ulnar styloid processes. midway between the radial

7. CARPAL TUNNEL - Axial Axial – method 1 Position of patient The patient stand with their back towards the table The cassette is placed level with the edge of the tabletop The palm of the hand is pressed on to the cassette, with the wrist joint dorsiflexed to approximately 135 degrees immobilization The fingers are curled around under the table to assist in

8. • The vertical central ray is centred between the pisiform and the hook of the hamate medially and the tubercle of the scaphoid and the ridge of the trapezium laterally Central Ray KVP - 65 mAs - 6 IR Size 18 × 24 cm (8 × 10 inch)

9. Axial – method 2 Position of patient The patient is seated alongside the table The cassette is placed on top of a plastic block approximately 8 cm high. The lower end of the forearm rests against the edge of the block, with the wrist adducted and dorsiflexed to 135 degrees This position is assisted using a traction bandage held by the patient’s other hand.

10. The vertical central ray is centred between the pisiform and the hook of the hamate medially and the tubercle of the scaphoid and the ridge of the trapezium laterally Central Ray KVP - 65 mAs - 6 IR Size 18 × 24 cm (8 × 10 inch)

11. Postero-anterior Position of patient The patient is placed in a sitting position. The hand is protonated on the image receptor (IR). Place the hand tightly on the IR with digits slightly flexed. Place the wrist joint at the center of IR. Lower the shoulder to align the joints of wrist, elbow and shoulder in a straight line.

12. The vertical central ray is centred to a point midway between the radial and ulnar styloid processes Central Ray KVP- 60 mAs- 6 IR Size 18 × 24 cm (8 × 10 inch)

13. Lateral Position of patient The patient is placed in a sitting position. Place the hand on image receptor (IR) in the true lateral position. Place the second to fifth fingers vertically on the IR and stack on one another. Adjust the posture to align wrist joint and elbow joint in a straight line. Place the radial styloid process perpendicular to IR.

14. The vertical central ray is centred over the styloid process of the radius Central Ray KVP - 60 mAs - 9 IR Size 18 × 24 cm (8 × 10 inch)

15. Wrist AP Oblique Position of patient The patient is placed in a sitting position. Supinate the filming hand and place the hand on 45° support block in internal rotation state. Adjust the posture to align wrist joint and elbow joint in a straight line. Place scaphoid perpendicular to image receptor (IR).

16. • The vertical central ray is centred midway between the radial and ulnar styloid processes. Central Ray IR Size 18 × 24 cm (8 × 10 inch) KVP- 60 mAs - 8

17. Wrist PA Oblique Position of patient The patient is placed in a sitting position. Protonate the filming hand and place the hand on 45° support block in external rotation state. Adjust the posture to align wrist joint and elbow joint in a straight line. Place scaphoid perpendicular to image receptor (IR).

18. Central Ray perpendicular beam directed at the wrist joint IR Size 18 × 24 cm (8 × 10 inch) KVP- 60 mAs - 8

19. Thank you ✨