Distal radius fracture x ray: Difference between revisions

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{{Distal radius fracture}}
{{Distal radius fracture}}
{{CMG}} {{AE}} {{VVS}}
{{CMG}}; {{AE}}  
==X Ray==
==Overview==
Diagnosis may be evident clinically when the distal radius is deformed but should be confirmed by x-ray. X-ray of the affected wrist is required if a fracture is suspected. CT scan is often performed to investigate the exact anatomy of the fracture, especially if surgery is considered. Investigation of a potential distal radial fracture includes assessment of the ''lateral articular angle'', ''radial length'', and ''articular surface''.
 
There are no x-ray findings associated with [disease name].
 
OR
 
An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR


===Lateral Articular Angle===
There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
The lateral articular angle is the angle between the axis of the radius and the articular cup. This angle is measured on x-ray films.
Normally, the angle is turned down toward the [[thumb]] (volar tilt) by 11°.
As pressure is applied to the radius, the cup may become aligned differently.
Alignment up to 0° is still considered to be functional, and does not require any intervention.
However, tilt away from the thumb (dorsal tilt) beyond this point (>11° deviation) requires reduction of the fracture.
When dorsal tilt beyond the acceptable threshold occurs, distal radio-ulnar joint motion is altered, and [[forearm]] rotation becomes restricted. The upper limit of an acceptable deformity after reduction of the fracture is 5° of dorsal tilt.


===Radial Length===
==X Ray==
Radial length is one of the important considerations in a distal radius fracture.
*Radiographic imaging is important in diagnosis, classification, treatment and follow-up assessment of distal radius fractures.<ref name="pmid8479720">{{cite journal| author=Metz VM, Gilula LA| title=Imaging techniques for distal radius fractures and related injuries. | journal=Orthop Clin North Am | year= 1993 | volume= 24 | issue= 2 | pages= 217-28 | pmid=8479720 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8479720  }} </ref><ref name="pmid18762124">{{cite journal| author=Henry MH| title=Distal radius fractures: current concepts. | journal=J Hand Surg Am | year= 2008 | volume= 33 | issue= 7 | pages= 1215-27 | pmid=18762124 | doi=10.1016/j.jhsa.2008.07.013 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18762124  }} </ref><ref name="pmid16039439">{{cite journal| author=Medoff RJ| title=Essential radiographic evaluation for distal radius fractures. | journal=Hand Clin | year= 2005 | volume= 21 | issue= 3 | pages= 279-88 | pmid=16039439 | doi=10.1016/j.hcl.2005.02.008 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16039439  }} </ref><ref name="pmid16039440">{{cite journal| author=Slutsky DJ| title=Predicting the outcome of distal radius fractures. | journal=Hand Clin | year= 2005 | volume= 21 | issue= 3 | pages= 289-94 | pmid=16039440 | doi=10.1016/j.hcl.2005.03.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16039440  }} </ref>
The core question that must be answered is "is it short?"
*The routine minimal evaluation for distal radius fractures must include two views-a postero-anterior (PA) view and lateral view.
The radius length would be too short if there is greater than neutral variance, especially when compared to the opposite side of the body.
*Postioning for the x-rays:
If the radial length remains uncorrected, [[ulnar impaction syndrome]] may occur.
**The posteroanterior view should be acquired with the patient’s elbow and shoulder at 90° and the forearm in neutral rotation.
**When the lateral view is acquired correctly, i.e., in the absence of relative pronation or supination, the pisiform bone should be superimposed on the distal pole of the scaphoid.


===Articular Surface===
Any articular joint surface must be smooth for it to function properly.
The surface is not smooth if there is more than 1 [[millimeter|mm]] step deformity, and is associated with posttraumatic [[arthrosis]].
Irregularity may result in radiocarpal [[arthritis]], [[Pain and nociception|pain]], and stiffness.
If the surface is very irregular, the optimal treatment is fusion.


==References==
==References==

Revision as of 18:12, 11 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

There are no x-ray findings associated with [disease name].

OR

An x-ray may be helpful in the diagnosis of [disease name]. Findings on an x-ray suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

There are no x-ray findings associated with [disease name]. However, an x-ray may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].

X Ray

  • Radiographic imaging is important in diagnosis, classification, treatment and follow-up assessment of distal radius fractures.[1][2][3][4]
  • The routine minimal evaluation for distal radius fractures must include two views-a postero-anterior (PA) view and lateral view.
  • Postioning for the x-rays:
    • The posteroanterior view should be acquired with the patient’s elbow and shoulder at 90° and the forearm in neutral rotation.
    • When the lateral view is acquired correctly, i.e., in the absence of relative pronation or supination, the pisiform bone should be superimposed on the distal pole of the scaphoid.


References

  1. ↑ Metz VM, Gilula LA (1993). "Imaging techniques for distal radius fractures and related injuries". Orthop Clin North Am. 24 (2): 217–28. PMID 8479720.
  2. ↑ Henry MH (2008). "Distal radius fractures: current concepts". J Hand Surg Am. 33 (7): 1215–27. doi:10.1016/j.jhsa.2008.07.013. PMID 18762124.
  3. ↑ Medoff RJ (2005). "Essential radiographic evaluation for distal radius fractures". Hand Clin. 21 (3): 279–88. doi:10.1016/j.hcl.2005.02.008. PMID 16039439.
  4. ↑ Slutsky DJ (2005). "Predicting the outcome of distal radius fractures". Hand Clin. 21 (3): 289–94. doi:10.1016/j.hcl.2005.03.001. PMID 16039440.

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