3 View Standard Hand Radiology Tutorial

Summary

Dr. Jamie Motley's tutorial covers the standard radiographic examination of the hand, detailing the anatomical structures visible in various projections such as PA, medial oblique, and lateral. Key points include identifying the carpal bones, the common scaphoid fractures due to FOOSH injuries, and the unique appearance of the lunate in lateral views. The tutorial also emphasizes the importance of recognizing carpal-metacarpal joints, phalanges, and potential fractures, providing a comprehensive guide for medical professionals.

Takeaways

• 📚 The script covers a standard radiographic examination of the hand, highlighting the importance of different projections such as PA, medial oblique, and lateral for evaluating hand anatomy and pathology.
• 🔍 The anatomical structures of the wrist, including the ulna, radius, and carpal bones, are essential to understand for accurate radiographic interpretation.
• 💡 The scaphoid bone is the most commonly fractured carpal bone, often due to 'FOOSH' injuries, which occur when a person falls on an outstretched hand.
• 🌙 The lunate bone's crescent shape is particularly visible in lateral projections and is crucial for identifying certain conditions and fractures.
• 👀 The script emphasizes the importance of careful observation of the wrist anatomy, especially the scaphoid's waist, which is the most common site for fractures.
• 👈 The metacarpal bones articulate with the carpals and phalanges, forming the carpometacarpal and metacarpophalangeal joints, which are significant for hand function.
• 🤞 The thumb has a unique anatomy with only two phalanges, the proximal and distal, and no middle phalanx, unlike the other four fingers.
• 👉 The lateral projection is particularly useful for identifying fractures, such as those of the triquetrum, and for evaluating the direction of fractures or displacements.
• 👁 The distal phalanx's tuft is a notable feature that can be important in certain conditions causing bone resorption under the fingertips.
• 🛡 The triangular fibrocartilage complex in the wrist is not visible on radiographs but is important for cushioning the space between the ulna and carpals.
• 🔑 The script provides a comprehensive guide to understanding hand anatomy in radiographic examinations, which is key for medical professionals in diagnosing and treating hand-related conditions.

Q & A

What is the purpose of the video tutorial by Dr. Jamie Motley?

The purpose of the video tutorial is to cover a standard radiographic examination of the hand, including standard projections and normal anatomy.

What are the standard projections of the hand mentioned in the script?

The standard projections of the hand include PA (posteroanterior), lateral, and oblique hand projections.

Why are accessory projections useful in radiographic examinations?

Accessory projections are useful for evaluating anatomy that is not well seen or for further evaluation of pathology that needs more detailed assessment.

What is the most common carpal bone to fracture, and what type of injury typically causes this?

The scaphoid is the most common carpal bone to fracture, and it usually occurs due to FOOSH injuries, which are falls on an outstretched hand.

What is the significance of the lunar shape in the lateral projection of the hand?

The lunar shape in the lateral projection refers to the lunate bone, which is easily identifiable due to its crescent moon-like appearance.

What is the role of the triangular fibrocartilage in the wrist?

The triangular fibrocartilage cushions the space between the ulna and the carpals, playing a crucial role in the stability and flexibility of the wrist joint.

How many bones are in the proximal row of the carpal bones, and what are they?

There are four bones in the proximal row of the carpal bones: the scaphoid, lunate, triquetrum, and pisiform.

What are the three main parts of a metacarpal bone?

The three main parts of a metacarpal bone are the base (near the carpal metacarpal joint), the shaft (the thinner midsection), and the head (the slightly rounded end).

How many phalanges are there in the fingers, and what are the differences between the thumb and the other digits?

There are 14 phalanges in the fingers, with three phalanges (proximal, middle, and distal) in each of the second through fifth digits, and two phalanges (proximal and distal) in the thumb.

What is the significance of the distal tuft of the distal phalanx?

The distal tuft of the distal phalanx is a semi-bulbous feature that can be important in certain conditions causing resorption of bone directly under the fingertips.

Why is the lateral projection useful for identifying certain fractures?

The lateral projection is useful for identifying certain fractures, such as triquetral fractures, due to the different orientation that reduces overlap of bones and allows for better visualization of the fracture site.