5/29/2023 0 Comments Normal wrist xrayIf the lunate is abnormally tilted in a volar direction a VISI should be considered.ĭISI (dorsal intercalated segmental instability) If the lunate is abnormally tilted in a dorsal direction on a standard lateral wrist image, a DISI should be considered. A simple approach is to consider the lunate which is usually the easiest carpal bone to visualise on a lateral wrist image. ![]() p206ĭon't be put-off by the apparent complexity of the deformities. It has a natural tendency if isolated to 'pop out' and tilt dorsally."Īdam Greenspan. It is controlled by the bones surrounding it via the short interosseous ligaments. The lunate is like the hooker of a rugby scrum. ![]() The proximal row acts as an intercalated segment- there is no direct control of this row. "The row concept best explains the behaviour of the carpal bones. The wrist positioning approach described above will tend to produce two views of the anatomy at 90 degrees because the relationship between the radius and ulna does not change- the 90 degree movement occurs largely at the shoulder. The positions as described above are akin to 'mixed forearm' views which are performed when patients have limited movement in their arm (usually from pain) or when the patient has an above elbow cast. The radiography technique textbooks do not consider the position of the forearm/elbow when describing wrist positioning. ![]() These descriptions are from radiology-based texts rather than radiography texts. Ueli Büchler, Federation of European Societies for Surgery of the Hand. 2 Examination and Diagnosis of Musculoskeletal DisordersĮxamination and Diagnosis of Musculoskeletal Disorders.Gilula and Ileana Chesaru Wrist - Carpal instability 1 Examination and Diagnosis of Musculoskeletal Disorders.
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