Evaluation of the Painful Wrist
The initial radiologic evaluation of the painful wrist should consist of a minimum of posteroanterior, lateral, and oblique projections. If the pain is localized to the anatomic snuff box, a posteroanterior view in ulnar deviation is added to this routine. Many patients without obvious fracture or dislocation have chronically painful wrists. The evaluation of these patients is considerably more difficult than those with acute trauma. A “wrist instability series,” which consists of a minimum of the routine films, as well as posteroanterior films with radial and ulnar deviation, is sometimes necessary. Gilula and Weeks also advocate lateral views in flexion and extension and a “carpal-loading,” anteroposterior view of the wrist with a clenched fist . This carpal instability series may bring out subtle, abnormal relationships between the carpal bones, particularly rotary subluxation of the navicular bone.
KeywordsCarpal Bone Painful Wrist Ulnar Deviation Ulnar Styloid Navicular Bone
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